某市三甲综合性医院2013—2015年医院感染调查与分析

Investigation of nosocomial infections at a tertiary care hospital in 2013—2015

目的了解珠海市人民医院2013—2015年全院医院感染的基本情况,为该医院制定预防控制医院感染的有效措施,提高医院感染管理水平提供理论依据。方法采取回顾性调查方法,获得该院医院感染相关数据进行描述性分析。结果 2013—2015年该院感染例次分别为769、619及541例次,例次感染率分别为1.66%、1.44%、1.43%,总例次感染率为1.51%。感染部位以肺炎构成比最高,其次为上呼吸道感染、泌尿道感染。医院感染发生率最高的科室依次为重症医学科、康复科、神经外科。共送检病原菌1 797例,检出率为71.01%,其中检出1 276例病原菌,革兰阴性菌占60%以上。在分离出的病原体当中,以铜绿假单胞菌(13.71%)、肺炎克雷伯菌(12.46%)、金黄色葡萄球菌(9.64%)最为常见。在检出的病原菌中,有603例致肺炎(46.58%),51例致泌尿道感染(3.96%)。肺炎主要由铜绿假单胞菌、白假丝酵母及肺炎克雷伯菌所致。结论虽然该院医院感染率较低,但仍应加强对高危科室的目标性监测,高危人群的预防,医护人员的相关培训以控制医院感染的发生。

Objective To investigate the nosocomial infections （NIs） at a tertiary care hospital in 2013-- 2015, and provide a theoretical support in developing effective measures for improving quality of medical care. Methods A retrospective observation was conducted at a tertiary care hospital from January 2013 to December 2015. Laboratory and hospital data were used to determine NIs rates, infection site distribution and pathogen profile. Results The prevalence of NIs was 1.66% in 2013, 1.44% in 2014 and 1.43% in 2015. Pneumonia accounted for approximately half of the total number of infection sites. ICU, rehabilitation department and neurosurgery department were top three wards with higher prevalence of NIs. 1 276 pathogenic organisms were isolated. Among them, Gram-negative bacteria accounted for more than 60%. The most frequently isolated pathogen was Pseudomonas aeruginosa （13.71%）, followed by Klebsiella pneumonia （12.46%） and Staphylococcus aureus （9.64%）. For pneumonia, the most common pathogen was Pseudomonas aeruginosa. Conclusion Although the prevalence of NIs is low in this hospital, it＇ s necessary for us to strengthen the target monitoring of high-risk departments, pay more attention in high-risk inpatients and increase related training for medical staff to control NIs.