武汉地区住院患者医院感染与社区感染现患率调查

Prevalence rates of healthcareassociated infection and communityassociated infection in hospitalized patients in Wuhan City

摘要:

目的了解武汉地区住院患者医院感染与社区感染现况，为医院感染的预防与控制提供依据。方法便利抽取武汉市33所医院，采用床旁调查和病例调查相结合的方法对住院患者进行调查，应用SPSS 16.0软件进行数据分析。结果调查住院患者36 222例，医院感染1 116例，医院感染现患率3.08%，社区感染6 968例，社区感染现患率19.24%。医院床位数≥900张者医院感染现患率最高（3.40%），医院床位数＜300张者社区感染现患率最高（43.70%）。医院感染现患率最高的科室为综合ICU（32.88%），社区感染现患率最高的科室为呼吸科（78.34%）。医院感染病例共检出病原体699株，主要为铜绿假单胞菌（18.03%）、鲍曼不动杆菌（16.31%）和金黄色葡萄球菌（12.88%），社区感染病例共检出病原体1 149株，主要为大肠埃希菌（14.45%）、铜绿假单胞菌（11.23%）和支原体（10.01%）。医院感染和社区感染主要部位均为下呼吸道，分别为48.24%和45.15%。结论该地区医院感染与社区感染呈现不同的特点，应根据重点科室、重点部位有针对性地采取措施，有效减少医院感染的发生。

Abstract:

ObjectiveTo investigate the prevalence rates of healthcareassociated infection(HAI) and communityassociated infection(CAI) in hospitalized patients in Wuhan City, and provide a scientific basis for the prevention and control of HAI. MethodsConvenience sampling method was used to select 33 hospitals in Wuhan City, all hospitalized patients were surveyed by bedside investigation and medical record reviewing, SPSS 16.0 software was used for data analysis. ResultsA total of 36 222 hospitalized patients were investigated, of whom 1 116 (3.08%) had HAI, 6 968 (19.24%) had CAI. The prevalence rate of HAI was highest in hospitals with ≥900 beds（3.40%）, and the prevalence rate of CAI was highest in hospitals with＜300 beds （43.70%）. Of departments, general intensive care unit had the highest prevalence rate of HAI(32.88%), department of respiratory diseases had the highest prevalence rate of CAI (78.34%). A total of 699 pathogens were isolated from patients with HAI, the top three were Pseudomonas aeruginosa (18.03%), Acinetobacter baumannii (16.31%) and Staphylococcus aureus (12.88%), a total of 1 149 pathogens were isolated from patients with CAI, the top three were Escherichia coli (14.45%), Pseudomonas aeruginosa (11.23%), and Mycoplasma (10.01%). The main infected sites of both HAI and CAI were the lower respiratory tract, accounting for 48.24% and 45.15% respectively. ConclusionHAI and CAI have different characteristics, it is necessary to take targeted measures according to key departments and key sites, so as to reduce the occurrence of HAI effectively.