某三级甲等医院3年医院感染现患率调查

Survey on prevalence rate of healthcareassociated infection in a hospital in three years

摘要:

目的了解某三级甲等医院医院感染的实际情况及变化趋势，有效预防与控制医院感染。 方法采用横断面调查方法，调查2010年5 月26 日、2012 年12 月12 日、2013 年12月4日所有住院患者，统计分析3年的资料。 结果2010、2012、2013年医院感染现患率分别为6.66%（116例）、6.67%（113例）和6.33%（120例），例次现患率分别为7.29%（127例次）、7.38%（125例次）和6.97%（132例次）。重症监护室（ICU）医院感染现患率最高，其中内科ICU高达71.43%。感染部位以下呼吸道居首位（44.53%），其次为手术部位（9.11%）和泌尿道感染（9.11%）。医院感染病原菌中，革兰阴性菌、革兰阳性菌和真菌分别占60.81%、20.38%、18.81%。3年抗菌药物使用率分别为32.95%、29.87%、25.59%，差异有统计学意义（χ2=13.16，P＜0.01）。 结论该院医院感染现患率较高，感染病原菌以革兰阴性菌为主，主要感染部位为下呼吸道；抗菌药物使用率逐年降低。应加强对感染高发科室、部位以及病原菌的监测，并采取相应干预措施。

Abstract:

ObjectiveTo investigate the prevalence rate of healthcareassociated infection(HAI) in a hospital, so as to provide reference for making HAI control measures. MethodsThe crosssectional survey on HAI was carried out among all hospitalized patients on May 26, 2010, December 12, 2012 and December 4, 2013, respectively, surveyed data were analyzed. ResultsThe prevalence rate was 6.66%(n=116）, 6.67%（n=113） and 6.33%（n=120）in 2010,2012 and 2013 respectively, and case rate was  7.29%（n=127）,7.38%（n=125）and 6.97%（n=132） respectively,  intensive care unit( ICU ) had the highest infection rate, internal medicine ICU was up to 71.43%. The main infection site was lower respiratory tract（44.53%）,  followed by surgical site infection (9.11%) and urinary tract infection (9.11%). The isolation rate of gramnegative bacteria,  grampositive bacteria and fungi was 60.81%, 20.38% and 18.81% respectively. Usage rate of antimicrobial agents in three years was 32.95%,29.87% and 25.59% respectively （χ2=13.16，P＜0.01）.ConclusionPrevalence rate of HAI in this hospital is high , the main pathogen is gramnegative bacteria, the main infection site is  lower respiratory tract , antimicrobial use  decreased year by year. Monitor on high risk departments, main sites and pathogens should be intensified.