2014-2016年某中医医院现患率调查分析

Survey and analysis on prevalence of nosocomial infection in a traditional Chinese medicine hospital from 2014 to 2016

目的调查分析2014-2016年医院感染现患率的各种数据变化,以了解医院感染现状。方法采用高年资医师床旁一对一调查及病历查阅的方式对2014-2016年同月份的3个时间段在院患者进行医院感染现患率调查。结果 2014-2016年调查的现患率均低于国家规定限制范围,2014年、2015年、2016年分别为3.58%、3.15%、2.82%;调查统计医院各科室现患率,2014年ICU最高,急诊科其次;2015年ICU最高,VIP病房其次;2016年仍然ICU最高,其次为新生儿科;连续3年现患率调查发现,主要感染部位为下呼吸道感染,其次为切口、上呼吸道,胃肠道、口腔、皮肤软组织感染;根据3年病原学统计,金黄色葡萄球菌感染最多,其次为鲍氏不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、真菌等;抗菌药物使用率2014年、2015年、2016年分别为37.52%,39.47%,41.35%,均低于卫生部抗菌药物使用率50.00%的标准。结论临床上应加强感染管理的质量控制、手卫生、无菌操作等,还应针对高危人群,高发部位的目标性监测,制定应对措施,降低医院感染率。

OBJECTIVE To investigate and analyze the data on the prevalence of nosocomial infection in the traditional Chinese medicine hospital from 2014 to 2016,so as to understand overall level of nosocomial infection.METHODS The one-to-one survey at the bedside by senior-standing doctors and reviewing medical records were used for calculating the prevalence of nosocomial infection of in-patients during three periods basically among the same month from 2014 to 2016.RESULTS The prevalences from 2014 to 2016were all lower than the level regulated by the nation.The prevalences from 2014 to 2016were 3.58%,3.15% and 2.82%,respectively.The statistic analysis of the prevalence in different departments showed that,the highest department was ICU among the three years,and followed by emergency department,VIP ward,and neonatology department from 2014 to 2016,respectively.The survey continued for three years found that the main sites of infection were lower respiratory tract infection,followed by incision,upper respiratory tract,gastrointestinal tract,oral cavity,and skin and soft tissue infections.According to 3-year etiology data,Staphylococcus aureus infection was the most one common,followed by Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,fungi and so on.The antibacterial drug usuage rates were 37.52%in 2014,39.47%in 2015 and 41.35%in 2016,respectirely,which were all lower than 50% which was published by standard by of Ministry of Health.CONCLUSIONIt should strengthen the quality control of nosocomial infection management,hand hygiene,aseptic operation,etc.in clinic,and develop response measures of targeted monitoring for high-risk groups and high-risk areas,so as to reduce the nosocomial infection rate.