某医院2017—2021年医院感染现患率调查及危险因素分析

Investigation on incidence rate of nosocomial infection and risk factors analysis in a hospital from 2017 to 2021

目的了解某医院2017—2021年住院患者医院感染现患率,为精准落实医院感染控制提供依据。方法采用个案调查与床旁调查相结合方法,对某医院2017—2021年住院患者医院感染现状进行横断面调查;采用单因素分析和多因素logistic回归分析医院感染危险因素。结果该医院连续5年住院患者医院感染现患率为1.36%~3.07%,各年度医院感染现患率差异无统计学意义(χ^(2)=7.443,P=0.114)。综合ICU的医院感染现患率最高(33.33%)。医院感染部位以下呼吸道、泌尿道和切口感染为主,构成比分别为58.33%、25.00%和5.95%。医院感染病原菌以革兰阴性菌为主,构成比为80.77%。住院患者抗菌药物使用率为24.83%~31.53%。抗菌药物以单用和治疗用药为主。脑卒中、多发伤、慢性气道疾患、昏迷和留置导尿管是医院感染的危险因素。结论该医院住院患者医院感染现患率处于较低水平,下呼吸道感染仍是感染防控的重点,需要关注重点人群、重点科室、重点环节的精准感染控制措施落实。

Objective To investigate the incidence rate of nosocomial infection of inpatients in a hospital from 2017 to 2021,and to provide evidence for precise implementation of nosocomial infection control.Methods A cross-sectional investigation was conducted to investigate the nosocomial infection of inpatients in a hospital from 2017 to 2021 by case investigation and bedside investigation.The risk factors of nosocomial infection were analyzed by univariate analysis and multivariate logistic regression analysis.Results The incidence rate of nosocomial infection from 2017 to 2021 was 1.36%-3.07%,and the difference was not statistically significant(χ^(2)=7.443,P=0.114).The incidence of nosocomial infection in ICU was the highest(33.33%).The main nosocomial infection sites were respiratory tract infection,urinary tract infection and incision infection,with the proportions of 58.33%,25.00%and 5.95%,respectively.The pathogenic bacteria of nosocomial infection were mainly Gram-negative bacteria,the composition ratio was 80.77%.The utilization rate of antibiotics in inpatients was 24.83%-31.53%.Antibiotics were mainly used singly and combination with therapeutic drugs.Stroke,multiple injuries,chronic airway diseases,coma,and indignant catheters were risk factors for nosocomial infections.Conclusion The nosocomial infection rate of inpatients in this hospital is at a low level,and lower respiratory tract infection is still the focus of infection prevention and control.Accurate infection control measures should be implemented in key populations,key departments and key links.