2018-2020年江苏省苏州市某三级综合医院医院感染特征及危险因素分析

Characteristics and risk factors of hospital infection in a tertiary hospital in Suzhou,Jiangsu,from 2018 to 2020

目的评价苏州市某三级综合医院医院感染特征及变化趋势,分析其危险因素,为医院感染防控提供参考依据。方法通过医院感染在线监测系统收集2018-2020年出院病例的相关信息,应用SPSS 23.0对数据进行整理和分析。结果出院患者共计67789例,1332例发生医院感染,年均感染发生率1.96%;2018-2020年医院感染发生率依次为2.10%、1.92%和1.84%,呈逐年下降趋势(P=0.046);科室医院感染率顺位前5位依次为神经外科(含神经外科重症监护室)、肿瘤内科、康复科、放疗科和重症医学科;医院感染的部位以下呼吸道感染为主;检出菌以肺炎克雷伯菌占比最高。Logistic回归分析结果显示:有中心静脉置管(OR=2.441,95%CI:2.231~2.670)、住院时间为8~14 d(OR=2.702,95%CI:2.401~3.041)或≥15 d(OR=12.104,95%CI:10.852~13.500)、年龄≥65岁(OR=1.768,95%CI:1.493~2.095)以及男性(OR=0.787,95%CI:0.723~0.857)是发生医院感染的危险因素。结论该院医院感染发生率逐年下降;中心静脉置管、住院时间、年龄和性别为男性是患者发生医院感染的危险因素。

Objective To evaluate the characteristics and trend of hospital infection in a tertiary hospital in Suzhou from 2018 to2020,and provide a reference for future hospital infection control.Methods The data of the discharged cases with hospital infection from 2018 to 2020 through the hospital infection online monitoring system were collected,and SPSS 23.0 was used to analyze the data.Results A total of 67789 patients discharged from the hospital from 2018 to 2020,among whom,1332patients developed hospital infection.The annual average incidence of hospital infection was 1.96%;the incidence of hospital infection from 2018 to 2020 was 2.10%,1.92%and 1.84%in turn,showing a year by year downward trend(P=0.046).Departments of neurosurgery(including NICU),oncology,rehabilitation,radiotherapy,and intensive care were the top five departments of hospital infections;in the 3 years,hospital infections were mainly lower respiratory tract infections;Escherichia coli accounted for the highest proportion of pathogenic bacteria,and the proportions of Pseudomonas aeruginosa and Klebsiella pneumoniae increased.Logistic regression analysis showed that central static tube(OR=2.441,95%CI:2.231-2.670),the length of hospital stay was 8-14 days(OR=2.702,95%CI:2.401-3.041)or≥15 days(OR=12.104,95%CI:10.852-13.500)and age≥65years(OR=1.768,95%CI:1.493-2.095)were risk factors for hospital infection;male patients(OR=0.787,95%CI:0.723-0.857)had a higher risk of hospital infection.Conclusion The incidence of hospital infection in this hospital is decreasing year by year.Central venous catheterization,length of hospital stay,age and gender(males)are risk factors for hospital infection in patients.