2020年—2022年云南省综合性医院的医院感染现患率分析

Analysis of the prevalence rate of healthcare-associated infection in comprehensive hospitals of Yunnan Province from 2020 to 2022

目的了解床位数≥900张综合性医院的医院感染现状,为下一步制订医院感染防控措施提供参考依据。方法回顾性收集2020年—2022年云南省医院床位数≥900张的综合性医院的医院感染现患率数据,分析各年度医院感染情况及变化趋势。结果共纳入综合医院119所,调查患者166745例,发生医院感染3237例;感染部位以下呼吸道感染和泌尿道感染为主;医院感染现患率最高的科室是重症监护病房,其次是神经外科和血液病科。2020年—2022年医院感染现患率呈下降趋势,差异有统计学意义(2.08%vs.1.99%vs.1.79%;χ^(2)=14.301,P<0.001)。共检出医院感染病原体1315株,均以革兰阴性菌为主,其中以大肠埃希菌和肺炎克雷伯菌较常见。2020年—2022年抗菌药物使用率、病原学送检率均呈上升趋势(χ^(2)=79.233、23.866,P<0.001),Ⅰ类手术部位切口感染、Ⅰ类手术患者预防性抗菌药物使用率均呈下降趋势(χ^(2)=15.551、6.311,P<0.05)。结论目前,云南省综合医院的医院感染现患率呈下降趋势。但对重点科室的监管、病原体防控措施的落实和住院患者抗菌药物的合理使用仍是今后工作的重点。

Objective To understand the current situation of healthcare-associated infection(HAI)in comprehensive hospitals with a number of beds≥900,and provide a reference for the next step in formulating HAI prevention and control measures.Methods The data on the prevalence rate of HAI in comprehensive hospitals witha number of beds≥900 of Yunnan Province between 2020 and 2022 were retrospective collected.The HAI situation and trend in each year were analyzed.Results A total of 119 comprehensive hospitals were included,with 166745 patients surveyed and 3237 cases of HAI.Lower respiratory tract infection and urinary tract infection were the most common sites.The department with the highest incidence of hospital infections was the intensive care unit,followed by neurosurgery and hematology.The prevalence rates of HAI showed a downward trend from 2020 to 2022(2.08%vs.1.99%vs.1.79%,χ^(2)=14.301,P<0.001).A total of 1315 strains of hospital-acquired pathogens were detected,all of which were mainly Gram-negative bacteria,with Escherichia coli and Klebsiella pneumoniae being more common.The rate of antibiotics use and the rate of pathogen testing showed an upward trend from 2020 to 2022(χ^(2)=79.233,23.866,P<0.001),the infection rate of incision site and the prophylactic use rate of antimicrobial drugs in patients with classⅠsurgery both showed a decreasing trend(χ^(2)=15.551,6.311,P<0.05).Conclusions The prevalence of infection in comprehensive hospitals of Yunnan Province is decreasing.But the supervision of key departments,the implementation of pathogen prevention and control measures,and the rational use of antibiotics in inpatients are still the focus of future work.