住院患者医院感染患病率调查分析

Investigation and analysis of prevalence rate of nosocomial infections in hospitalized patients

目的分析医院感染患病率调查结果的变化趋势,为提高医院感染预防控制水平提供科学依据。方法以横断面调查的方式,调查分析医院住院患者的感染发生现状,对2012-2015年4次调查结果进行比较分析。结果应调查患者4476例,实际调查4473例,实查率99.93%;4473例患者中发生医院感染172例,181例次,医院感染现患率3.85%,例次现患率为4.05%;2012-2015年医院感染现患率逐年降低,但各年度之间差异无统计学意义(χ~2=4.66,P=0.20);住院患者医院感染现患率高发科室为重症医学科、胸外科、血液儿科、血液内科、肾移植科、肾病科等;医院感染的感染部位前5位依次为下呼吸道、血液系统、上呼吸道、泌尿道和手术部位,分别占48.07%、16.57%、9.94%、6.08%和6.08%;医院感染首位病原体为肺炎克雷伯菌,22株占18.03%;抗菌药物总使用率为29.4%,2012-2015年抗菌药物使用率有下降趋势(χ~2=77.07,P<0.01)。结论医院感染现患率调查可有效反映医院感染情况及其相关因素,医院感染控制逐年改进,抗菌药物合理使用管控成效显著。

OBJECTIVE To investigate the change of prevalence rate of nosocomial infections so as to provide scientific basis for prevention and control of the nosocomial infections.METHODS By means of cross-sectional survey,the prevalence rate of nosocomial infections in the hospitalized patients was investigated,and the results of 4 surveys that were conducted from 2012 to 2015 were observed and compared.RESULTS Totally 4476 patients were supposed to be investigated,and 4473 patients were actually investigated,with the actual investigation rate 99.93%.Of the 4473 patients,172（181 case-times）had nosocomial infections,with the prevalence rate 3.85%（case-time prevalence rate 4.05%）.The prevalence rate of nosocomial infections was decreased year by year from 2012 to 2015,however,there was no significant difference among the four years（χ^2=4.66,P=0.20）.The prevalence rate of nosocomial infections was high in the hospitalized patients of critical care medicine department,department of thoracic surgery,pediatric department of hematology,hematology department,kidney transplantation department and department of nephropathy.The lower respiratory tract,blood system,upper respiratory tract,urinary tract and surgical sites ranked the top 5 nosocomial infection sites,accounting for 48.07%,16.57%,9.94%,6.08%and 6.08%,respectively.Klebsiella pneumoniae was the predominant pathogen causing the nosocomial infection,accounting for 18.03%（22 strains）.The total utilization rate of antibiotics was 29.4%,and the utilization rate of antibiotics showed a downward trend from 2012 to 2015（χ^2=77.07,P〈0.01）.CONCLUSION The survey of prevalence rate of nosocomial infections may effectively reflect the status of nosocomial infections and related factors,facilitate the control of nosocomial infections and help to achieve remarkable effect on reasonable use of antibiotics.