166所综合医院医院感染管理监控指标调查

Investigation on the monitoring indicators of nosocomial infection management in 166 hospitals

目的了解某省不同规模医院的医院感染现状及抗菌药物使用情况。方法对2015年某省166所不同规模综合医院的医院感染管理监控指标进行调查,统计不同规模综合医院的医院感染发病率、Ⅰ类切口手术部位感染率、医务人员手卫生依从率、抗菌药物治疗前病原学标本送检率、多药耐药菌感染检出率、住院患者抗菌药物使用率和Ⅰ类切口手术抗菌药物预防使用率,对比分析不同规模综合医院的各项院感监测指标的差异。结果共调查住院患者4382871例,医院感染新发病例数为82681例,医院感染发病率为1.9%,Ⅰ类切口手术部位感染率为0.3%,医务人员手卫生依从率为67.9%,抗菌药物治疗前病原学标本送检率为50.5%,多药耐药菌感染检出率为21.4%,住院患者抗菌药物使用率52.7%,Ⅰ类切口手术抗菌药物预防使用率为33.2%;不同规模综合医院的各项院感监测指标差异均有统计学意义(P<0.05)。结论不同规模综合医院的各项院感监测指标存在差异;需进一步规范小规模医院感染管理工作;Ⅰ类切口手术抗菌药物预防使用率偏高,需对抗菌药物合理使用加强管理。

OBJECTIVE To investigate the status of nosocomial infections（NI）and the use of antimicrobial drugs in different scale of hospitals in a province.METHODS Investigation on the monitoring indicators of NI management in 166 hospitals of a province was carried out.The incidence of nosocomial infections,surgical site infection rate of type I incision,hand hygiene compliance rate of medical personnel,pathogen submission rate before antibacterial drug treatment,detection rate of multidrug-resistant bacteria infections,utilization rate of antibiotics in inpatients and prophylactic use rate of antibiotics in type I incision surgery were statistically recorded in different scales of general hospitals,and the differences of the monitoring indicators in different scales of hospitals were compared and analyzed.RESULTS A total of 4382871 inpatients were investigated,82681 cases of NI occurred,and the incidence of NI was 1.9%,Surgical site infection rate of type I incision was 0.3%,hand hygiene compliance rate of medical staff was 67.9%,pathogen submission rate before antibacterial drug treatment was 50.5%,detection rate of multidrug-resistant bacteria infections was 21.4%,utilization rate of antibiotics in inpatients was 52.7%,and prophylactic use rate of antibiotics in type I incision surgery was 33.18%.The differences in different scales of hospitals were significant（P〈0.05）.CONCLUSION There are differences in the monitoring indicators of NI in different scales of hospitals.The infection monitoring of small scale of hospitals needs to be further standardized.The rate of prophylactic antibiotic application for type I surgical incision is high,and rational use of antibiotics is needed.