某三级综合医院2008-2018年医院感染现患率调查

Prevalence rates of nosocomial infection in a tertiary hospital from 2008 to 2018

目的评价2008-2018年医院感染现患率连续变化趋势,为确定医院感染防控重点、制定有效的医院感染干预措施提供依据。方法采用横断面调查的方法,对2008-2018年住院患者进行医院感染现患率调查。使用卡方检验及Cochran-Armitage趋势检验对调查数据进行统计分析。结果 2008-2018年间医院感染现患率较为平稳,在4.00%~5.46%之间波动,无明显差异(χ^2=11.213,P=0.344)。医院感染部位以下呼吸道感染为主。医院感染病原菌以革兰氏阴性菌为主,且占比逐年上升(Z=-2.080,P=0.038),其中肺炎克雷伯菌占比上升明显(Z=-4.845,P<0.001)。抗菌药物使用率逐年下降(Z=7.922,P<0.001),治疗性使用抗菌药物患者送检率逐年上升(Z=-8.457,P<0.001)。结论医院感染控制情况总体平稳,抗菌药物使用管理有所进展,下一步需加强对肺炎克雷伯菌相关感染的防控。

OBJECTIVE To evaluate the prevalence rates of nosocomial infection in 2008-2018 so as to define the key points of prevention of nosocomial infection and develop effective intervention measures. METHODS By means of cross-sectional survey, the prevalence rates of nosocomial infection were investigated among the hospitalized patients from 2008 to 2018. The survey data were statistically analyzed by using chi-square test and Cochran-Armitage trend test. RESULTS The prevalence rates of nosocomial infection ranged between 4.00% and 5.46% in 2008-2018, and there was significant difference(χ~2=11.213,P=0.344). The patients with lower respiratory tract infection were dominant among the patients with nosocomial infection. The gram-negative bacteria were the predominant pathogens causing the nosocomial infection, of which the constituent ratio was increased year by year( Z=-2.080, P=0.038);the constituent ratio of Klebsiella pneumoniae was increased significantly(Z=-4.845, P<0.001). The utilization rate of antibiotics was decreased year by year( Z=7.922, P<0.001). The submission rate of microbial specimens of the patients who were treated with antibiotics was increased year by year( Z=-8.457, P<0.001). CONCLUSION The prevalence of nosocomial infection is basically stable, while the progress has been made in antibiotics management, and it is necessary to further strengthen the prevention and control of the K.pneumoniae infection.