东莞市13所三级医院医院感染现患率调查

survey on point prevalence of healthcare-associated infection in 13 tertiary hospitals in Dongguan

目的通过首次开展东莞市13所三级医院医院感染现患率调查,了解东莞市三级医院医院感染情况,为指导医院感染的预防与控制提供依据。方法采用床旁调查和查阅病历相结合的方法,调查东莞市13所三级医院2014年9月24日0:00-24:00期间的住院患者医院感染情况。结果共调查患者11 344例,发生医院感染379例,404例次,医院感染现患率为3.34%,例次现患率为3.56%。重症监护病房(ICU)医院感染例次现患率最高(12.82%)。医院感染部位主要为呼吸道(173例次,占42.82%)。抗菌药物使用率为30.50%,以治疗用药(包括治疗+预防用药)为主(2 545例,占73.55%),一联用药为主(2 689例,占77.72%),治疗用药患者病原微生物标本送检率为53.79%。医院感染病例共检出299株病原菌,主要为大肠埃希菌(56株,占18.73%)、铜绿假单胞菌(54株,占18.06%)、肺炎克雷伯菌(35株,11.71%),检出多重耐药菌(MDR)92株,占所有病原菌的30.77%。结论通过调查初步了解了全市三级医院医院感染的基本特点,应加强高风险科室、高危人群、高风险环节的识别,落实医院感染预防与控制措施。

Objective To survey the point prevalence of healthcare-associated infection（HAI）in13 tertiary hospitals in Dongguan,understand the occurrence of HAI in tertiary hospitals,so as to provide guidance for the prevention and control of HAI.Methods Through bedside investigation and medical record reviewing,HAI among inpatients in 13 tertiary hospitals in Dongguan at 0：00-24：00of September 24,2014 were investigated.Results A total of 11 344 patients were investigated,379 patients developed 404 times of HAI,HAI rate was 3.34%,HAI case rate was 3.56%.Incidence of HAI in the intensive care unit was highest（12.82%）.The main infection site was respiratory tract（n=173,42.48%）.The usage rate of antimicrobial agents was 30.50%,most were for therapeutic use（including therapeutic＋ prophylaxis）（n=2 545,73.55%）and single use（n=2 689,77.72%）,pathogenic microorganism detection of specimens from patients receiving therapeutic antimicrobial use was 53.79%.A total of299 strains of pathogenic orgamisms were detected from infected patients,the major were Escherichia coli（n=56,18.73%）,Pseudomonas aeruginosa（n=54,18.06%）,and Klebsiella pneumoniae（n=35,11.71%）,92 strains of multidrug-resistant organisms（MDROs）were isolated,accounting for 30.77% of total isolated pathogens.Conclusion The basic characteristics of HAI in tertiary hospitals in this city were preliminarily investigated,identification of high risk departments,high risk population,and high risk links should be strengthened,HAI prevention and control measures should be implemented.