2020年成都市某三级甲等医院住院患者医院感染横断面调查

Cross⁃sectional study of nosocomial infection among inpatients in a tertiary hospital in Chengdu,2020

【目的】了解并掌握某三级甲等(以下简称“三甲”)专科医院住院患者医院感染现况,为制定医院感染预防控制措施及开展针对性目标性监测提供科学依据。【方法】采用横断面调查方法,利用医院感染电子系统对成都某三甲医院2020年12月23日0:00—24:00院内543例住院患者进行调查。【结果】共发生医院感染23例,合计26例次,医院感染现患率4.24%,医院感染例次率4.79%;发生社区感染127例,合计132例次,社区感染现患率23.39%,社区感染例次率24.31%。重症医学科(72.73%)是医院感染现患率最高的科室,各科室医院感染现患率差异有统计学意义(χ^(2)=148.870,P<0.05);医院感染和社区感染部位均以下呼吸道为主,医院感染与社区感染的感染部位差异有统计学意义(χ^(2)=22.942,P=0.011)。在医院感染和社区感染的病原体中,以革兰阴性菌(56.92%)占比最高,其中主要以大肠埃希菌(16株)和肺炎克雷伯菌(10株)为主。全院抗菌药物使用率为31.68%,以治疗性使用抗菌药物(80.23%)和一联用药(88.95%)为主,治疗用抗菌药物中病原体送检率为72.08%。【结论】医院感染现患率调查能全面了解医院感染情况,应开展对重症医学科和多重耐药菌的目标性监测,规范抗菌药物合理使用,提高医务人员控制院内感染意识,有效降低院内感染发生。

[Objective]To investigate the prevalence of nosocomial infection among inpatients in a tertiary hospital,and provide scientific evidence for hospital infection control and targeted surveillance.[Methods]A cross-sectional survey was conducted to investigate a total of 543 hospitalized patients using the hospital information system.[Results]The prevalence of hospital-acquired infection(HAI)was 4.24%,and that of community-acquired infection(CAI)was 23.39%.HAI prevalence differed significantly among the departments(χ^(2)=148.870,P<0.05),and was highest in the department of intensive care medicine(72.73%).Sites of infection were significantly different between HAI and CAI(χ^(2)=22.942,P=0.011);however,the most frequent site of infection was lower respiratory tract in both HAI and CAI.Major pathogens for nosocomial infection were Gram-negative bacteria(56.92%),mainly Escherichia coli and Klebsiella pneumoniae.Antimicrobial usage was observed in 31.68%of the patients,principally for therapeutic use of antibacterial drugs(80.23%)and a combination of drugs(88.95%).Examination rate of pathogens following the antimicrobial usage was 72.08%.[Conclusion]The investigation on the prevalence of nosocomial infection may facilitate fully understanding the nosocomial infection.It warrants strengthening the monitoring in the departments of intensive care medicine and on multi-resistant bacteria,and achieving antimicrobial stewardship,so as to improve the awareness of hospital infection control in medical staff'and effectively reduce the occurrence of nosocomial infection.