2015—2019年某三甲医院医院感染现状分析

Current situation of nosocomial infection in a tertiary level-A hospital from 2015 to 2019

目的了解医院感染的现况及发展特点,为有效预防和控制医院感染,制订控制措施提供参考。方法采用回顾性调查方法,通过医院感染病例监测系统和HIS系统获取某三甲医院2015—2019年医院感染数据,计算和分析各年度的感染发生率、感染部位和病原菌分布情况。结果2015—2019年医院感染发生率依次为1.34%、1.51%、1.31%、1.19%和1.05%,总体呈下降趋势;不同年龄段住院患者发生医院感染的情况分析发现其发生风险呈现U形分布,随着年龄的增加先降低后升高,其中0~20岁和71岁以上的住院患者发生医院感染的风险明显高于21~70岁的患者;重症医学部医院感染发生率最高,为10.66%;下呼吸道感染是首要的感染部位,占28.41%,且每年占比均居首位;医院感染病原学检查送检率为74.53%,病原菌分离阳性率为57.67%;检出革兰阴性菌占57.01%,虽每年占比均居首位但呈下降趋势(χ^(2)=10.81,P<0.01);革兰阳性菌占27.04%,呈增长的趋势(χ^(2)=33.80,P<0.01)。结论该医院医院感染发生率总体呈下降趋势;年龄是影响患者发生医院感染的重要因素,重点防控上呼吸道部位感染和革兰阴性菌的引起的感染。

Objective To understand the current situation and development characteristics of nosocomial infection,and to provide theoretical basis for effective prevention and control of nosocomial infection and formulation of control measures.Methods Retrospective investigation was used to obtain the data of nosocomial infection from 2015 to 2019 through hospital medical record system and monitoring system of nosocomial infection.The incidence rate of nosocomial infection in each year,site of infection and pathogen distribution were calculated and statistically analyzed.Results The incidence of nosocomial infection from 2015 to 2019 were 1.34%,1.51%,1.31%,1.19%and 1.05%,showed a downward trend.The risk of nosocomial infection in the hospitalized patients of different ages showed a U-shape distribution,which was first reduced and later increased with increasing age,and the inpatients aged 0 to 20 years and over 71 years had a significantly higher risk of nosocomial infection than the patients aged 21 to 70 years.The departments with the highest incidence of hospital infection was the department of critical care medicine(10.66%).The lower respiratory tract infection was the primary infection site(28.41%)and had the highest annual proportion.The etiological examination rate of nosocomial infection was 74.53%,and the positive rate of pathogen isolation was 57.67%,mainly gram-negative bacteria.The Gram-negative bacteria accounted for 57.01%,ranking first every year but decreasing(χ^(2)=10.81,P<0.01).Gram-positive bacteria accounted for 27.04%,showed an increasing trend year by year(χ^(2)=33.80,P<0.01).Conclusion The incidence of nosocomial infections in this hospital has showed on a downward trend.Age is an important factor affecting the nosocomial infection,focus on the prevention and control of upper respiratory tract site infection and infection caused by gram-negative bacteria.