2018年上海市宝山区医院感染现患率调查

Survey on prevalence of nosocomial infection in Baoshan District of Shanghai in 2018

目的了解2018年上海市宝山区各级医疗机构医院感染现状和抗菌药物使用及微生物送检情况,为进一步预防和控制医院感染提供科学依据。方法采用横断面调查方法,对上海市宝山区18所不同级别医院2018年12月11日0~24时期间住院患者进行医院感染现患率的调查。结果调查患者共4772例,实查率100%,现患率1.91%,例次现患率1.93%;专科、一、二、三级医院感染现患率依次为2.60%、2.41%、1.85%和1.19%;医院感染现患率前3位分别为综合重症监护病房(11.54%)、老年护理(5.99%)、外科病房(3.22%);感染部位主要以下呼吸道为主(63.04%);检出的病原菌中主要以革兰氏阴性菌为主(60.53%),以铜绿假单胞菌居首位;抗菌药物平均使用率为19.49%,二三级医院、一级医院、专科医院抗菌药物使用率分别为24.60%、5.35%、2.60%;治疗性使用抗菌药物前微生物平均送检率为74.90%,二三级医院、一级医院、专科医院微生物送检率分别为78.80%、10.00%、0。结论全面了解上海市宝山区各级医疗机构医院感染现状,针对不同级别医院以及医院感染率较高的科室、部位进行重点监测和干预,规范抗菌药物使用及微生物送检,制定并严格落实各项感染防控措施,减少医院感染的发生。

Objective To understand the current situation of nosocomial infections in medical institutionsat all levels in Baoshan District of Shanghai in 2018,obtain the status of use of antibiotics and microbial detection,and provide scientific basis for further prevention and control of nosocomial infections.Methods A cross-sectional survey was conducted to investigate the prevalence of nosocomial infection among inpatients in 18 hospitals of different levels in Baoshan District of Shanghai from 00:00 to 24:00 on December 11,2018.Results A total of 4 772 patients were investigated.The actual rate was 100%,the prevalence rate was1.91%,and the case prevalence rate was 1.93%.The prevalence rate of nosocomial infections in specialized hospitals,primary hospitals,secondary hospitals and tertiary hospitals was 2.60%,2.41%,1.85%and 1.19%,respectively.The top three departments of nosocomial infection rates were comprehensive ICU(11.54%),geriatric nursing(5.99%)and surgical ward(3.22%).The main infection sites were lower respiratory tract(63.04%).Gram-negative bacteria were the main pathogens detected(60.53%),which was dominated by Pseudomonas aeruginosa.The average usage rate of antibiotics was 19.49%,and the usage rate of antibiotics in secondary and tertiary hospitals,primary hospitals and specialized hospitals was 24.60%,5.35%and 2.60%respectively.The average rate of microbiological examination rate before the use of antibiotics was 74.90%,and the rate of microbial examination in secondary and tertiary hospitals,primary hospitals and specialized hospitals was 78.80%,10.00%and 0.00%respectively.Conclusion It is necessary to fully understand the current situation of nosocomial infection in hospitals at all levels in Baoshan District of Shanghai,focus on monitoring and intervention for different levels of hospitals and departments and locations with high nosocomial infection rate,standardize the use of antibiotics and microbial inspection,and formulate and strictly implement various infection prevention and control measures,to reduce the occurrence of nosocomial infection.