我国不同类型医院的医院感染及耐药情况的评估调查

The healthcare-associated infection and multidrug resistance characteristics among different types of hospitals in China

目的:分析全国143家不同类型医院的医院感染和多重耐药菌感染情况,为有效预防和控制医院感染提供科学依据。方法:采用2018年"全国进一步改善医疗服务行动计划第三方评估"调查数据。结果:全国143家三级公立医院的医院感染发病(例次)率为1.15%,医院感染现患(例次)率为2.26%,医院感染病例漏报率为5.30%。综合医院的医院感染发病率和现患率最高,分别为(1.48±0.91)%和(3.12±1.49)%,妇幼医院最低,分别为(0.83±0.71)%和(1.65±1.27)%,差异具有统计学意义(P <0.05)。全国143家三级公立医院耐碳青霉烯鲍曼不动杆菌感染发现率最高(1.69%),其次为耐甲氧西林金黄色葡萄球菌感染发现率(1.12%),耐万古霉素肠球菌感染发现率最低(0.07%)。耐碳青霉烯鲍曼不动杆菌感染检出率最高(39.25%),其次为耐甲氧西林金黄色葡萄球菌感染检出率(26.6%)和耐碳青霉烯铜绿假单胞菌感染检出率(19.49%),耐万古霉素肠球菌感染检出率最低(1.48%)。结论:我国三级公立医院医院感染总体发生和控制情况较好。建议相关部门应加强政策和措施的力度,多部门协作共同防控多重耐药菌引起的医院感染,加强医院感染和耐药的控制。

Objective: We aim to analyze the Characteristics of healthcare-associated infection(HI)and multi-drug resistance(MDR)in 143 medical institutions in China across different types, so as to provide evidence based data for the effective prevention and control of healthcare-associated infection. Methods: We use the data from The China Healthcare Improvement Evaluation Survey(CHIES)in 2018. Results: The incidence of healthcare-associated infection was 1.15% in 143 hospitals in China, the prevalence of healthcare-associated infection was 2.26%, and the rate of underreporting of healthcare-associated infection was 5.30%. The incidence and prevalence of healthcare-associated infection in general hospitals were the highest(1.48±0.91)% and(3.12±1.49)% respectively, and those in women’s and children’s hospitals were the lowest(0.83±0.71)% and(1.65±1.27)% respectively. The difference was statistically significant(P < 0.05). Among 143 hospitals in China, Acinetobacter baumannii infection rate was the highest(1.69%), followed by methicillin-resistant Staphylococcus aureus infection rate(1.12%), vancomycin resistant enterococci infection rate was the lowest(0.07%). The highest infection rate was Acinetobacter baumannii(39.25%), followed by methicillin-resistant Staphylococcus aureus(26.6%), carbapenem resistant. Pseudomonas aeruginosa(19.49%), vancomycin resistant Enterococcus(1.48%). Conclusion: The overall incidence and control of healthcare-associated infection in tertiary public hospitals are better. It is suggested that the relevant departments should strengthen the capacity for related policies and measures, work through multiple departments collaboration to prevent and control healthcare-associated infection caused by multidrug-resistant bacteria, and strengthen measures to control healthcare-associated infection and drug resistance.