新冠疫情期间肿瘤医院住院患者医院感染及相关因素分析

Analysis of Nosocomial Infection and Influence Factors of Inpatients in Oncology Hospitals during COVID-19 Pandemic

目的观察新型冠状病毒肺炎疫情防控期间,肿瘤专科医院住院患者医院感染相关变化情况。方法收集2020年1―6月新型冠状病毒疫情防控期间及2019年和2018年同期住院患者医院感染监测数据,对相关数据进行比较分析。结果与2019和2018年同期相比,新型冠状病毒肺炎疫情防控期间住院患者收治同比下降41.51%和34.54%,手术例数同比下降46.43%和43.51%,医院感染率和现患率下降至0.52%和0.80%,医院感染漏报率上升至30.16%,腹盆腔内组织感染和下呼吸道感染仍是最主要医院感染部位,医院感染致病菌中铜绿假单胞菌构成比上升至16.22%,大肠埃希菌构成比下降至10.81%,抗菌药物使用率和送检率有所下降。结论新型冠状病毒肺炎疫情对肿瘤患者住院及接受手术治疗方面产生较大影响。各项医院感染防控措施的强化落实有助于降低医院感染率和抗菌药物使用率,含氯消毒剂消毒频次增加能有效降低肿瘤患者发生大肠埃希菌感染的风险。新型冠状病毒肺炎疫情防控常态化管理下,临床需关注肿瘤患者发生铜绿假单胞菌感染的风险、及时上报医院感染病例以降低医院感染暴发风险。

Objective To observe the nosocomial infection-related changes of inpatients in the oncology hospital during the prevention and control of COVID-19 pandemic.Methods Nosocomial infection surveillance data of inpatients during the prevention and control of COVID-19 from January to June 2020 and the same period in 2019 and 2018 were collected.Relevant data was compared and analyzed.Results Compared with the same period in 2019 and 2018,the admission of hospitalized patients during the prevention and control of COVID-19 pandemic decreased by 41.51%and 34.54%year-on-year.The number of surgical cases decreased by 46.43%and 43.51%year-on-year,and the hospital infection rate and prevalence rate decreased to 0.52%and 0.80%.The missing report rate of nosocomial infections rose to 30.16%,abdominal and pelvic tissue infections and lower respiratory tract infections were still the most common nosocomial infections.The proportion of pseudomonas aeruginosa among the pathogens of nosocomial infections rose to 16.22%.The proportion of Escherichia coli decreased to 10.81%.The use rate of antibacterial drugs and the inspection rate decreased.Conclusion The COVID-19 pandemic has a great impact on the hospitalization and surgical treatment of cancer patients.The strengthened implementation of various nosocomial infection prevention and control measures can help reduce the nosocomial infection rate and the use of antibacterial drugs.The increase in the frequency of disinfection with chlorine-containing disinfectants can effectively reduce the risk of Escherichia coli infection in cancer patients.Under the normalized management of the prevention and control of COVID-19 pandemic,clinical attention should be paid to the risk of pseudomonas aeruginosa infection in tumor patients,and timely reporting of hospital infection cases to reduce the risk of hospital infection outbreaks.