住院患者2014-2016年医院感染现患率调查分析

Survey on nosocomial infection prevalence rate of inpatients from 2014 to 2016

目的了解医院感染现患率、抗菌药物使用及病原学送检情况,分析医院感染相关危险因素,为加强医院感染管理提供依据。方法采用横断面调查的方法,分别于2014年8月20日、2015年8月13日、2016年8月17日0:00-24:00对某医院住院患者的医院感染现患率进行调查与分析。结果 2014-2016年共发生医院感染37例,医院感染现患率为3.12%,感染例次率为4.30%;3年间医院感染现患率无明显差异;医院感染现患率居于前3位的科室为重症医学科、干部病房和神经外科,分别占13.33%、10.96%和5.52%;感染部位主要为下呼吸道,占41.18%,其次为泌尿道(19.61%)和皮肤软组织(15.69%);抗菌药物使用以治疗性用药和一联用药为主,3年抗菌药物使用率分别为35.85%、33.86%和34.09%,标本病原学送检率分别为43.16%、46.24%和48.51%,各年度间差异无统计学意义。医院感染病原菌分布以革兰阴性杆菌为主,占82.35%。医院感染的危险因素为年龄(≥60岁)、手术、血液透析、气管切开、使用呼吸机、动静脉置管及泌尿道置管。结论加强医院感染高发科室、高发部位的监测,针对医院感染危险因素采取有效预防与控制措施,从而降低医院感染发生率。

Objective To understand the prevalence rate of nosocomial infections,the use of antimicrobial and the submission of pathogens of nosocomial infections,and analyze risk factors of nosocomial infections,so as to provide basis to strengthen nosocomial infections control. Methods By means of cross-sectional survey,the prevalence rates of nosocomial infections from 0： 00 to 24： 00 on August 20,2014,August 13,2015,and August 17,2016 were investigated and analyzed.Results There were 37 cases of infection from 2014 to 2016,the infection rate was 3. 12% and case infection rate was4. 30%. There was no significant difference in three years. The prevalence rates of the top three departments were ICU（13. 33%）,cadre ward（10. 96%）,and neurosurgery（5. 52%）. The lower respiratory tract was infected most,accounting for 41. 18%,followed by the urinary tract（19. 61%） and the skin soft tissue（15. 69%）. Single using and for theray were the main reason in the use of antimicrobial drugs. Three years of antimicrobial drug utilization rates were 35. 85%,33. 86%,and 34. 09%,respectively. The pathogenic detection rates were 43. 16%,46. 24%,and 48. 51%,respectively,and there was no significant difference. Gram-negative bacteria were highly detected in 82. 35%. Risk factors of nosocomial infection were age（≥60 years）,surgery,hemodialysis,tracheotomy,with respirator,arteriovenous catheterization,and urinary tract catheterization. Conclusion To strengthen the monitor over the high prevalence of the department and the high prevalence of the site and adopt effective prevention and control measures to deal with risk factors of infection so as to reduce hospital infection rates.