常德市某三甲医院2015~2018年医院感染横断面调查

Cross-sectional survey of nosocomial infection in a third-grade hospital in Changde from 2015 to 2018

目的 对某三级甲等医院2015~2018年医院感染横断面调查结果进行分析,为医院感染风险防控提供科学依据.方法 采取个案调查、床旁调查和查阅电子病历相结合的横断面调查方法,调查某三甲医院2015~2018年某日所有住院患者医院感染发生情况及抗菌药物使用情况等.结果 2015~2018年医院感染横断面共调查住院患者8991例,实查率99.67%,平均医院感染现患率为2.98%;重症监护病房医院感染现患率最高.感染部位以下呼吸道为主.横断面抗菌药物日使用率为43.69%,治疗性使用抗菌药物病原学送检率67.46%.2015~2018年医院感染横断面调查日共检出病原菌184株,其中检出细菌前五位分别为:铜绿假单胞菌(22.28%)、鲍曼不动杆菌(16.85%)、金黄色葡萄球菌(15.76%)、肺炎克雷伯菌(15.22%)、大肠埃希菌(13.04%).结论 该院连续四年医院感染现患率及抗菌药物使用率均不高.各科室和感染部位情况提示重症监护病房、下呼吸道感染仍是医院感染控制的重点.

Objective To analyze the results of cross-sectional survey of nosocomial infection in a third-grade hospital in 2015~2018,and provide scientific evidence for prevention and control of infection risk in tertiary hospitals.Methods A cross-sectional survey method combining case investigation,bedside survey and electronic medical record was used to investigate the incidence of nosocomial infection and the use of antibiotics in all hospitalized patients in a third-grade hospital in 2015~2018.Results In 2015~2018,a total of 8991 inpatients were investigated in the cross-section of nosocomial infection.The actual investigation rate was 99.67%,and the average hospital infection rate was 2.98%.The hospital infection rate was the highest in the intensive care unit.The respiratory tract is mainly below the infected site.The daily use rate of cross-section antibiotics was 43.69%,the therapeutic use rate of therapeutic antibiotics was 67.22%.A total of 184 pathogens were detected on the cross-sectional survey of nosocomial infections in 2015~2018,of which the top five bacteria were Pseudomonas aeruginosa(22.28%),Acinetobacter baumannii(16.85%),Staphylococcus aureus(15.76%),Klebsiella pneumoniae(15.22%)and Escherichia coli(13.04%).Conclusion The hospital's prevalence rate of hospital infection and antibiotic use rate are not high for four consecutive years.The situation of various departments and infection sites suggest that intensive care unit and lower respiratory tract infection are still the focus of hospital infection control.