某三甲医院2014-2016年医院感染现患率调查分析

Investigation on prevalence rate of nosocomial infections in a third grade hospital from 2014 to 2016

目的了解某三甲医院医院感染的实际情况及变化趋势,对2014-2016年医院感染现患率进行分析,为有效预防与控制医院感染提供依据。方法采用床旁调查与病历调查相结合的横断面调查方法,调查该院2014-2016年某一日所有住院患者的医院感染现患率、感染控制重点科室医院感染现患率、医院感染部位及病原菌分布以及病原菌送检率。结果 2014-2016年医院感染总现患率为4.22%,感控重点科室医院感染总现患率前3位的科室为血液科、干部病房、神经外科(P<0.05);医院感染部位排前3位是下呼吸道、上呼吸道、泌尿系统,分别占51.22%、15.12%、9.27%;医院感染病例检出病原菌排前3位的病原菌为铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌,分别占26.87%、15.67%、8.21%;革兰阴性菌构成比>真菌构成比>革兰阳性菌构成比;近3年医院感染病原微生物送检率差异无统计学意义。结论目前医院感染预防控制形势不容忽视,预防控制工作需持续用力。医务人员应加强预防感染意识和病原微生物送检意识,对感染患者做到早发现、早诊断、早治疗,以提高感染的诊治水平。

OBJECTIVE To investigate the actual situation and changing trend of nosocomial infections in a third grade hospital,and analyze the prevalence rate of nosocomial infections from 2014 to 2016,so as to provide basis for effective prevention and control of nosocomial infections.METHODS Using across-sectional survey method of clinical investigation and case investigation,the prevalence rate of nosocomial infections,the prevalence rate of nosocomial infections in key departments of infection control,nosocomial infection sites,and pathogens distribution among all inpatients in the hospital from 2014 to 2016were investigated.RESULTS The total prevalence rate of nosocomial infections was 4.22%from 2014 to 2016,and the top 3departments of the total prevalence rate of key departments of infection control were：Department of Hematology,cadre ward,Department of Neurosurgery（P〈0.05）.The top 3nosocomial infection sites were lower respiratory tract,upper respiratory tract,and urinary tract,accounting for 51.22%,15.12%,and 9.27%,respectively.The top 3pathogenic bacteria of nosocomial infections were：Pseudomonas aeruginosa,Klebsiella pneumoniae,and Bauman Acinetobacter,accounting for 26.87%,15.67%,and 8.21%,respectively.The composition ratio order was gram-negative bacteria fungigram-positive bacteria.There was no significant difference in the inspection rate of pathogenic microorganisms of nosocomial infections in recent 3years.CONCLUSIONThe current situation of nosocomial infection prevention and control should not be ignored,and prevention and control work needs to continue to force.The medical staff should strengthen the awareness of prevention of infections and pathogenic microorganisms inspection,to achieve early discovery,early diagnosis and early treatment,so as to improve the level of diagnosis and treatment of infection.