精神病专科医院连续4年医院感染现患率调查

Prevalence rates of healthcareassociated infection in a psychiatric hospital in four consecutive years

摘要:

目的了解某精神病专科医院医院感染现患率和抗菌药物使用状况。方法对2012—2015年该院每年6月20日0：00—24：00所有住院精神病患者进行医院感染横断面调查，分析4年的医院感染情况。结果实查住院患者2 584例，发生医院感染47例、48例次，医院感染现患率为1.82%，例次现患率为1.86%；2012—2015年医院感染现患率分别为2.09%、1.56%、1.48%、2.11%，总体差异无统计学意义（χ2=1.23,P=0.75）。医院感染现患率居前3位的科室依次是医疗救治科男区（3.80%）、急性干预科男区（3.31%）、老年精神科（2.78%）。感染部位居前3位的依次是上呼吸道、下呼吸道、胃肠道，分别占31.91%、29.79%、14.89%；检出病原菌28株，居前３位的依次为大肠埃希菌（28.58%）、肺炎克雷伯菌（17.86%）、金黄色葡萄球菌（14.29%）。2012—2015年抗菌药物使用率分别为10.91%、5.78%、5.41%、5.06%，逐年下降，差异有统计学意义（χ2=23.13，P＜0.01）。结论连续4年该精神病医院医院感染现患率保持在较低水平，抗菌药物使用率逐年下降。

Abstract:

ObjectiveTo investigate the prevalence rates of healthcareassociated infection (HAI) and antimicrobial use in a psychiatric hospital. MethodsThe annual crosssectional survey on HAI among all hospitalized psychiatric patients from 0:00 to 24:00 of June 20, 2012-2015 were conducted, HAI during 4 years were analyzed. ResultsA total of 2 584 hospitalized patients were surveyed, 47 patients had 48 episodes of HAI， the prevalence rate and case prevalence rate of HAI were 1.82% and 1.86% respectively；prevalence rates in 2012-2015 were 2.09%, 1.56%, 1.48%, and 2.11% respectively（χ2=1.23, P=0.75）. The top three departments of high prevalence rates were male section of medical rescue department（3.80%）, male section of acute intervention department（3.31%）, and department of geriatric psychiatry（2.78%）. The top three infection sites were upper respiratory tract (31.91%), lower respiratory tract (29.79%), and gastrointestinal tract(14.89%); 28 strains of pathogenic bacteria were detected, the top three pathogens were Escherichia coli (28.58%), Klebsiella pneumoniae (17.86%), and Staphylococcus aureus (14.29%); antimicrobial use rates in 2012-2015 were 10.91%, 5.78%, 5.41%, and 5.06% respectively, which decreased year by year（χ2=23.13，P＜0.01）. ConclusionPrevalence rates of HAI in four consecutive years maintained a low level in this hospital, antimicrobial usage rates decreased year by year.