某综合性医院2016-2018年医院感染现患率调查

Survey of prevalence rate of healthcare-associated infection in a general hospital in 2016-2018

目的了解某综合性医院医院感染现患情况,为提高医院感染管理水平提供参考依据。方法采用横断面调查方法,分析不同性别、年龄、科室的医院感染现患率,感染部位分布及病原菌耐药情况。结果 2016-2018年医院感染现患率分别为3. 37%、2. 17%和2. 62%,3年间差异无统计学意义。男性医院感染现患率高于女性,不同年龄组住院患者医院感染现患率大致呈"U"型分布,但不同性别和年龄组医院感染差异均无统计学意义(P>0. 05)。医院感染率较高的科室为重症医学科(ICU)和儿科;感染部位前3位的依次为下呼吸道、手术部位(器官/腔隙)和泌尿道,分别占28. 33%、25. 00%和15. 00%。检出病原菌前5位的依次为鲍曼不动杆菌、大肠埃希菌、屎肠球菌、金黄色葡萄球菌和肺炎克雷伯菌。2016-2018年耐药菌所占比例逐渐增多,差异有统计学意义(P=0. 01)。结论该院医院感染管理的重点人群为儿童和老年患者,重点科室为ICU和儿科,需重点关注下呼吸道感染和手术部位(器官/腔隙)感染,加强多重耐药菌防控管理措施落实。

Objective To investigate the prevalence of healthcare-associated infection(HAI)in a general hospital to facilitate the improvement of HAI management.Methods Using cross-sectional survey,prevalence rates of HAI,constituent ratios of HAI sites and drug-resistance of pathogens in patients of different genders,age groups and departments were analyzed.Results The prevalence rates of HAI in 2016-2018 were 3.37%,2.17%and 2.62%,respectively,without statistically significant difference among the three years.The prevalence rate of HAI in males was higher than that in females.The prevalence rates of HAI in hospitalized patients of different age groups were roughly U-shaped distribution,but there was no significant difference in neither gender nor age groups(P>0.05).The departments with high HAI rate were Intensive Care Unit(ICU)and pediatric department;the top three sites of infection were the lower respiratory tract,surgical site(lacuna)and urinary tract,accounting for 28.33%,25.00%and 15.00%respectively.The top 5 pathogens were Acinetobacter baumannii,Escherichia coli,Enterococcus faecium,Staphylococcus aureus and Klebsiella pneumoniae.The ratio of drug-resistant bacteria increased gradually in 2016-2018 with statistical significance(P=0.01).Conclusion Prevention and control of HAI should focus on the children and elder,the ICU and pediatric department,and the lower respiratory tract and surgical site(lacuna)infection,and the management of multidrug-resistant organisms should be strengthened.