某新建综合医院598例医院感染分析

Analysis of 598 Cases of Nosocomial Infection in a New Comprehensive Hospital

目的了解某大学教学医院新建分院医院感染的特点和相关因素,探讨新建医院有效预防和控制医院感染的措施。方法对2012年4月-2014年6月598例医院感染病例进行分析,统计医院感染发生率、感染部位、病原菌监测、抗菌药物使用及相关因素等指标。结果 2012年4月-2014年6月共出院44 085例次,医院感染598例次,例次感染率为1.36%。医院感染发生率较高的科室分别为重症医学科(9.79%)、骨科(2.98%)、老年科(2.62%)和血液内科(1.64%);感染部位以下呼吸道感染为主,占45.32%,其次为泌尿道(13.21%)、切口(8.86%)和血液(8.86%)感染。598例感染病例中有570例送检,送检率为95.32%;病原菌以鲍曼不动杆菌(17.02%)、肺炎克雷伯菌(14.21%)、大肠埃希菌(13.68%)、铜绿假单胞菌(11.93%)和金黄色葡萄球菌(9.12%)最为常见;感染病例的相关高危因素中,泌尿道插管居首位,占42.81%;其次为入住重症医学科和使用免疫抑制剂及激素,分别占28.60%和26.42%。结论全面性综合监测不仅能帮助医院掌握医院感染散发病例中的高危科室、高危因素及高危人群等,而且为进一步预防和控制医院感染提供了合理有效的理论依据。

Objective To understand the characteristics of and risk factors for nosocomial infection in a newly built branch of a university teaching hospital, in order to investigate the control measures for prevention and control of nosocomial infection. Methods A total of 598 cases of nosocomial infection from April 2012 to June 2014 were enrolled in this study. We analyzed statistically such indexes as nosocomial infection rate, infection site, pathogen detection, and use of antibiotics. Meantime, infection point-prevalence survey was introduced by means of medical record checking and bedside visiting. Results Among all the 44 085 discharged patients between April 2012 and June 2014, there were 598 cases of nosocomial infection with an infection rate of 1.36%. Departments with a high nosocomial infection rate included Intensive Care Unit （ICU） （9.79%）, Department of Orthopedics （2.98%）, Department of Geriatrics （2.62%）, and Department of Hematology （1.64%）. The top four nosocomial infection sites were lower respiratory tract （45.32%）, urinary tract （13.21%）, operative incision （8.86%）, and blood stream （8.86%）. The samples of 570 nosocomial infections were delivered for examination with a sample-delivering rate of 95.32%. The most common pathogens were acinetobacter Baumanii （17.02%）, Klebsiella pneumoniae （14.21%）, Escherichia coli （13.68%）, Pseudornonas aeruginosa （11.93%）, and Staphylococcus aureus （9.12%）. And urinary tract intubation （42.81%）, admission of ICU （28.60%）, and application of corticosteroid and immunosuppressive agents （26.42%） were the top three independent risk factors for nosocomial infection. Conclusion General and comprehensive monitoring is an effective method for the hospital to detect high-risk departments, factors and patients for nosocomial infection, providing a theoretical basis for prevention and control of nosocomial infection.