2011—2015年某县级医院医院感染现患率调查

Prevalence rates of healthcare-associated infection in a county hospital from 2011to 2015

目的了解2011—2015年某县级医院医院感染现状、常见感染部位及抗菌药物使用情况。方法采取床旁调查和病历调查相结合的方法,选取2011年4月26日、2012年4月25日、2013年5月14日、2014年9月9日、2015年8月12日为调查日,调查当日0:00-24:00所有住院患者医院感染情况,将调查数据录入SPSS 17.0软件进行统计分析。结果 5次现患率调查共调查患者5 165例,医院感染患者132例、138例次,医院感染现患率2.56%、例次现患率2.67%。平均现患率最高的科室为重症监护病房(ICU),高达22.58%。医院感染部位以下呼吸道为主(占58.70%),其次是泌尿道(12.32%)、上呼吸道(10.14%)及皮肤软组织(5.07%)等。共检出病原菌45株,以革兰阴性菌为主(30株,占66.67%)。抗菌药物总使用率为45.27%,5次现患率调查抗菌药物使用率分别为61.48%、43.89%、37.81%、39.43%、44.79%。抗菌药物使用目的以治疗用药为主(包括治疗+预防),占78.27%;联合用药方面以单一为主,占81.27%。结论连续5年现患率调查,使医院感染管理部门更加全面了解该院医院感染重点科室、重点患者、重点部位及抗菌药物使用情况,为制定和实施符合该院实际情况的医院感染防控措施提供依据。

Objective To investigate the healthcare-associated infection（HAI） status, common infection sites, and antimicrobial use in a county hospital in 2011-2015.Methods With combination of bedside survey and case history reviewing, HAI among all hospitalized patients at 0：00-24：00 on April 26, 2011, April 25, 2012, May 14, 2013, September 9, 2014, and August 12, 2015 were surveyed, survey data were analyzed by software SPSS17.0.Results A total of 5 165 patients participated in 5 surveys of HAI prevalence rate, 132 patients had 138 cases of HAI, prevalence rate and case prevalence rate were 2.56% and 2.67% respectively.Intensive care unit had the highest average HAI prevalence rate（22.58%）.Lower respiratory tract was the main HAI site （58.70%）, followed by urinary tract （12.32%）, upper respiratory tract （10.14%）, and skin soft tissue（5.07%）.A total of 45 strains of pathogens were isolated, mainly gram-negative bacteria （n=30, 66.67%）.The total usage rate of antimicrobial agents was 45.27%, in 5 prevalence surveys were 61.48%, 43.89%, 37.81%, 39.43%, and 44.79% respectively.The main purpose of antimicrobial use was therapy （including therapy ＋ prevention）, accounting for 78.27%;monotherapy accounted for 81.27%.Conclusion Through prevalence rate survey for 5 consecutive years, HAI management departments can be more comprehensively understand HAI in key departments, key patients, key sites of HAI, and antimicrobial use in this hospital, and provide basis for the formulation and implementation of HAI prevention and control measures according to the actual situation of the hospital.