微生物室在医院感染控制中的作用调查

Effect of microbiology laboratory on control of nosocomial infections

目的调查微生物室在医院感染控制中的作用。方法 2016年1-3月以调查问卷形式,采取分层抽样的方法,随机选取江苏省13个地级市47所医院,统一向调查医院发放调查问卷,调查研究微生物室在医院感染控制中的作用。结果 47所医院均建立了单独的微生物室;47所医院中仅有5所(10.64%)三级医院配备微生物质谱分析仪;微生物室到临床科室会诊的三级医院22所多于二级医院3所(P=0.049)。仅有3所三级医院微生物室具备同源性鉴定能力。从2010-2015年,47所医院检出多药耐药菌(Multidrug-resistant Organism,MDRO)后使用信息系统备注此菌为MDRO的分别为5所(10.64%)、37所(78.72%),至少每季度向临床反馈病原微生物抗菌药物耐药性数据的分别为21所(44.68%)、39所(82.98%),开展痰培养前常规进行痰涂片镜检工作的分别为25所(53.19%)、41所(87.23%),开展血培养双侧双份的分别为9所(19.15%)、33所(70.22%),2010年和2015年数据比较差异有统计学意义(P均<0.05)。结论微生物室在医院感染防控建设中的作用,已有较明显的改进,但仍需进一步加强在感染管理中的自身建设。

OBJECTIVE To investigate the effect of microbiology laboratory on control of nosocomial infections.METHODS In the form of questionnaire,47 hospitals in 13 prefecture-level cities in Jiangsu province were randomly selected by stratified sampling method,and questionnaires were distributed to the survey hospitals to investigate the promotion and development of microbiology laboratory in nosocomial infection control.RESULTS Forty-seven hospitals have established separate microbiology laboratory.Only 5 of 47 hospitals（10.64%）were equipped with microbiological mass spectrometer.There were 22 third-class hospitals and 3 second-class hospitals in the consultation from microbiological room to clinical department,and the difference was not significant（P=0.049）.Only 3 third-class hospitals have homology identification capability.Among the forty-seven hospitals,MDROs（multidrug-resistant organism,MDRO）were noted by information system after MDROs were detected in 5 hospitals（10.64%）and 37 hospitals（78.72%）from 2010 to 2015.Data on antimicrobial resistance of pathogenic microorganisms were monitored with quarterly feedback to clinical in 21 hospitals（44.68%）and 39 hospitals（82.98%）.There were 25 hospitals（53.19%）and 41 hospitals（87.23%）routinely conducted sputum smear microscopy before sputum culture.Blood culture of bilateral double parts was conducted in 9（19.15%）and 33 hospitals（70.22%）,respectively.The differences were significant between 2010 and 2015（all P〈0.05）.CONCLUSION The microbiology laboratory has significant effects in the prevention and control of nosocomial infections.However,there is still room for further strengthening,and the connection between infection control and clinic needs to be further strengthened.