2017年医院感染现患率调查及相关因素分析

Prevalence Rate of Nosocomial Infection in 2017 and Analysis of Related Factors

目的:调查了解医院感染的现患率情况,分析感染发生的危险因素,为感染发生的预防和治疗提供可供参考的依据。方法:以2017年10月19日0:00-24:00本院住院部725例住院患者为研究对象,采用横断面调查方法,借助医院感染实时监控系统对医院感染现患率进行调查,并对感染的科室分布、部位分布、病原学检测情况等进行分析。根据患者是否存在感染将其分为感染组、无感染组,比较感染组与无感染组的临床资料,对存在感染的危险因素进行单因素分析及多因素Logistic线性回归分析。结果:应查住院患者共725例,实查住院患者725例,共存在感染165人次(169例次),包括社区感染148人次(152例次)、医院感染17人次(17例次),医院感染现患率为2.34%(17例次)。科室分布方面,感染集中于呼吸内科、泌尿外科,其占比分别为17.58%(29例)、15.76%(26例)。感染的科室分布于重症监护室、烧伤整形科、呼吸内科、介入科、内分泌代谢科、口腔科、心血管内科、骨科、肾内科、消化内科。感染部位分布方面,多集中于下呼吸道,其余分布于皮肤、血液、泌尿道、胃肠道、上呼吸道、腔隙、其他。病原学检测结果显示,17例医院感染患者共检出病原体14例(16株),病原体阳性检出率为82.35%。单因素分析中,感染组与无感染组在性别、年龄、使用抗生素、行外科手术等方面比较均无统计学意义(P>0.05),而感染组与无感染组在留置导尿管、中心静脉插管、使用呼吸机、气管切开等方面比较,差异均有统计学意义(P<0.05)。经多因素Logistic线性回归分析后发现,留置导尿管、中心静脉插管、使用呼吸机、气管切开是导致医院感染发生的危险因素。结论:医院感染现患率调查可对医院感染情况予以真实反映,临床上应加强科室间合作,重点对下呼吸道感染进行监测,针对感染相关危险因素制定有效的预防方案。

Objective:To investigate the current prevalence rate of nosocomial infections and to analyze the risk factors of nosocomial infection,so as to provide evidences for the prevention and treatment of nosocomial infection.Method:A total of 725 inpatients in our hospital from 0:00 to 24:00 on October 19 2017 were enrolled in this study.The cross-sectional survey method was used to investigate the prevalence rate of nosocomial infection with the help of real-time monitoring system of nosocomial infection.And the distribution of infected departments,the distribution of parts,the etiology of detection and other conditions were analyzed.The patients were divided into infected group and non-infected group according to the presence or absence of infection.Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of infection.Result:A total of 725 inpatients should be investigated,725 inpatients were confirmed,and 165 coexisted infections(169cases),including 148 community infections(152cases),17 hospital infections(17cases),the prevalence of infection was 2.34%(17cases).Department distribution,infection concentrated in Respiratory Medicine,Urology,accounting for 17.58%(29cases),15.76%(26cases).Infected departments are located in the Intensive Care Unit,Burn and Plastic Surgery,Respiratory Medicine,Interventional Division,Endocrinology and Metabolism,Stomatology,Cardiology,Orthopedics,Nephrology,Gastroenterology.In terms of the distribution of the infected sites,most of them were concentrated in the lower respiratory tract.The rest were found in the skin,blood,urinary tract,gastrointestinal tract,upper respiratory tract,lacunar and others.Pathogenic test results showed that in 17 cases of hospital infection were detected in 14 cases of pathogens(16strains),the positive detection rate of pathogens was 82.35%.In univariate analysis,there were no significant difference in sex,age,use of antibiotics,surgical operation between two groups(P>0.05),while in infected group and non-infected group,indwelling cathete,center Venous catheterization,the use of breathing machine,tracheotomy,etc were statistically significant(P<0.05).By the multi-factor Logistic linear regression analysis found indwelling catheter,central venous catheterization,the use of breathing machine and tracheotomy were the risk factor for nosocomial infection.Conclusion:The survey of prevalence rate of nosocomial infection can reflect the actual situation of nosocomial infection.Clinically,we should strengthen the cooperation between departments,especially monitor lower respiratory tract infections,and establish effective prevention programs for the risk factors related to infection.