某呼吸专科医院2013-2017年医院感染现患率调查分析

Analysis on prevalence survey of healthcare-associated infection in a respiratory hospital from 2013 to 2017

目的了解某呼吸专科医院医院感染的特点和变化趋势,为医院感染防控提供依据。方法 2013-2017年每年选取1天采用床旁调查和查阅病历相结合的方法,对所有住院患者进行医院感染现况调查。结果 5年共调查患者3 057例,医院感染115例,平均现患率为3. 76%,2013-2017年现患率分别为5. 52%、4. 74%、3. 58%、3. 18%和1. 59%。现患率较高的科室为综合ICU、胸外科和肿瘤科。感染部位以下呼吸道感染为主,其次为上呼吸道和胃肠道。感染病原菌主要为鲍曼不动杆菌,其次为肺炎克雷伯菌、铜绿假单胞菌、嗜麦芽窄食单胞菌及真菌。抗菌药物使用率为41. 59%~51. 84%;治疗性使用抗菌药物病原学标本送检率为81. 79%~98. 20%。结论该院医院感染现患率及抗菌药物使用率均明显下降,医院感染防控与抗菌药物管理取得一定成效。

Objective To investigate the infection characteristics and tendency of healthcare-associated infection(HAI)in a respiratory hospital from 2013 to 2017,and provide scientific basis for the prevent and control of HAI.Methods The status of HAI in all hospitalized patients on the given days from 2013 to 2017 were investigated by combination of bedside investigation and medical record reviewing.Results A total of 3 057 patients were investigated from 2013 to 2017,115 of whom were HAI,with 3.76%of an average prevalence rate,5.52%,4.74%,3.58%,3.18%and 1.59%are prevalences respectively in the past five years.The departments with higher prevalence rate of HAI are general ICU,department of thoracic surgery and department of oncology.The main site of HAI was lower respiratory tract,followed by upper respiratory tract and gastrointestinal tract.The main pathogenic bacteria of HAI were Acinetobacter baumannii,followed by Klebsiella pneumoniae,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and fungi.The usage rate of antibiotics was 41.59%-51.84%.The pathogenic detection rate in patients receiving therapeutic antibiotics was 81.79%-98.20%.Conclusion The prevalence rate of HAI and the usage rate of antibiotics in the hospital have declined obviously,and the prevention and control of HAI and the management of antibiotics have made achievements.