肿瘤患者医院感染趋势分析及防控对策

Nosocomial Infection Analysis and Prevention on Cancer Patients

目的了解肿瘤患者医院感染和抗菌药物的使用情况及变化趋势,为制定医院感染防控措施提供参考。方法对浙江省肿瘤医院2011-2016年各年内某一时点住院患者医院感染和抗菌药物使用以及病原菌检出情况的调查结果进行统计分析。结果 2011-2016年医院感染现患率从5.3%降到3.2%,呈逐年下降趋势;医院感染部位以下呼吸道和手术部位为主;抗菌药物使用率分别为18.0%、21.0%、15.8%、14.3%、16.5%、15.8%,均以一联、预防用药为主;检出的病原菌主要为大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌等革兰氏阴性菌。结论肿瘤患者院内感染防控的重点是以革兰氏阴性菌为主的下呼吸道和手术部位感染,尤其应注意加强对多重耐药菌的管理。

Objective To learn noscomical infection and antibiotics use of cancer patients so as to provide reference for making prevention and control plans. Methods Statistic analysis on noscomical infection and antibiotics use as well as the survey resuhs of pathogenic bacteria of inpatients in Zhejiang Cancer Hospital in a certain time of each year from 2011 to 2016 was conducted. Results The prevalence rate of noscomical infection decreased from 5.3% in 2011 to 3.2% in 2016, which showed a decreasing trend year by year. Lower respiratory tract and surgical site were the major infection sites. The utilization rate of antibiotics from 2011 to 2016 was 18.0%, 21.0%, 15.8%, 14.3%, 16.5% and 15.8% respectively, which were mainly single medication and preventive medication. The main isolated pathogens were Gram-negative bacteria, like Escherichia coil, Pseudomonas aeruginosa and Acinetobacter bauma. Conclusion Prevention and control on noscomical infection of cancer patients should locus on Gram-negative bacteria-based lower respiratory tract infection and surgical site infection. In particular, the management on muhiple resistant bacteria should be strengthened.