包头地区二级及以上医院感染疾病防控能力现况调查

Investigation on prevention and control of infection at secondary or higher-level hospitals in Baotou

目的调查内蒙古包头市医院感染疾病防控能力,为各医院提升感染防控能力提供依据。方法2023年6月采取问卷星的方式对包头市所有二级及以上医院的医院感染情况及其防控情况进行调查,共计64所,秩和检验比较不同等级、类别的医院感染相关发病率;卡方检验比较不同等级医院感染管理及控制能力情况。结果64所医院的医院感染发病率[M(P25~P75)]为0.324%(0.141%~0.793%),医院感染现患率为1.216%(1.012%~2.004%),医院感染漏报率为0.537%(0.218%~2.733%)。二级医院与三级医院感染发病率分别为0.301%(0.011%~0.623%)、0.564%(0.239%~1.044%),差异有统计学意义(Z=-2.476,P=0.013);综合医院、专科医院的医院感染发病率分别为0.483%(0.166%~0.917%)、0.282%(0.044%~0.435%),差异有统计学意义(Z=-2.260,P=0.024)。二级医院Ⅰ类切口手术感染率、呼吸机相关肺炎感染率、导尿管相关泌尿系感染率、经外周置入中心静脉导管(PICC)相关血流感染率分别为0.060%(0~0.681%)、0.000%(0~0.703%)、0.000%(0~0.287%)、0.001%(0~0.101%),三级医院分别为0.013%(0~0.270%)、0.703%(0~1.540%)、0.287%(0~1.400%)、0.098%(0~0.101%),差异均有统计学意义(Z=-2.465,P=0.014;Z=-3.532,P<0.001;Z=-3.573,P<0.001;Z=-2.636,P=0.008)。二级医院与三级医院在信息系统建设能达到的要求方面比较,差异有统计学意义(χ^(2)=26.506,P<0.001)。结论包头地区二级及以上医院的医院感染发病率及患病率较低,应加强控制呼吸机相关肺炎、导尿管相关泌尿系感染;部分医院尤其二级医院对医院感染的防控还存在一些措施不到位的情况,应提升对医院感染的监督管理措施。

Objective This study investigated prevention and control of nosocomial infection in Baotou City,Inner Mongolia,to provide a basis for hospitals to improve capacity for infection prevention and control.Methods In June 2023,a Questionnaire Star questionnaire was used to investigate nosocomial infection,and its prevention and control,in all secondary or higher-level hospitals in Baotou(64 hospitals).The rank sum test was used to compare the incidence of various grades and categories of nosocomial infection,and chi-square test was used to compare the management and control ability of nosocomial infection in the different grades.Results The incidence of nosocomial infection in 64 hospitals was 0.324%(0.141%-0.793%).The prevalence rate of nosocomial infection was 1.216%(1.012%-2.004%),and the missing report rate for nosocomial infection was 0.537%(0.218%-2.733%).The incidence of nosocomial infection in secondary and tertiary hospitals was 0.301%(0.011%-0.623%)and 0.564%(0.239%-1.044%),respectively,and the difference was statistically significant(Z=-2.476,P=0.013).The incidence of nosocomial infection in general and specialist hospitals was 0.483%(0.166%-0.917%)and 0.282%(0.044%-0.435%),respectively,and the difference was statistically significant(Z=-2.260,P=0.024).The infection rates of typeⅠincisions,ventilator-associated pneumonia,urinary catheters,and central venous catheters(PICC)were 0.060%(0-0.681%),0.000%(0-0.703%),0.000%(0-0.287%),and 0.001%(0-0.101%),respectively,whereas the third-tier hospitals had rates of 0.013%(0-0.270%),0.703%(0-1.540%),0.287%(0-1.400%),and 0.098%(0-0.101%),respectively.The differences were statistically significant(Z=-2.465,P=0.014;Z=-3.532,P<0.001;Z=-3.573,P<0.001;and Z=-2.636,P=0.008).Requirements were met in the construction of information systems,and differences were observed between secondary hospitals and tertiary hospitals(χ^(2)=26.506,P<0.001).Conclusions Although the incidence and prevalence of nosocomial infection at secondary and higher-level hospitals in Baotou area are relatively low,measures against nosocomial infections of ventilator-associated pneumonia and urinary catheter related infections should be strengthened.Some measures are not in place for the prevention of nosocomial infection in some hospitals,particularly secondary hospitals;therefore,the supervision and management regarding nosocomial infection should be improved.