基层三甲医院2012—2015年医院感染现患率及危险因素

Prevalence and risk factors of healthcareassociated infection in a tertiary firstclass hospital in 2012-2015

摘要:

目的了解医院感染现患情况及其危险因素，为医院感染预防与控制提供依据。方法采用横断面调查的方法，床旁调查和查阅住院病历相结合，对2012—2015年某基层三甲医院住院患者进行医院感染现患率调查及危险因素分析。结果共调查住院患者4 725例，2012—2015年医院感染现患率分别为6.00%、4.77%、3.93%、3.05%，差异有统计学意义（P＜0.05）；抗菌药物使用率分别为30.56%，33.82%，32.84%，34.48%，差异无统计学意义（P＞0.05）；感染部位以下呼吸道为主（43.00%），其次为手术部位（16.43%）；年龄≥65岁、慢性全身性疾病（包括糖尿病，肝硬化，慢性肾功能不全，慢性肺部疾病），免疫缺陷（白细胞＜1.5×109/L）、昏迷、气管切开、使用呼吸机是医院感染的危险因素。结论医院感染现患率调查可促进医院感染管理持续改进，应加强手术部位感染监测和医院感染危险因素的评估。

Abstract:

ObjectiveTo understand the prevalence and risk factors of healthcareassociated infection(HAI), and provide evidence for prevention and control of HAI. MethodsA crosssectional survey was adopted, bedside survey and medical record reviewing method was combined to investigate and analyze the prevalence of HAI in a tertiary firstclass hospital in 2012-2015. ResultsA total of 4 725 hospitalized patients were surveyed，the prevalence rates in 2012-2015 were 6.00%，4.77%，3.93%，and 3.05% respectively, difference was significant（P＜0.05）； antimicrobial usage rates were 30.56%，33.82%，32.84%, and 34.48% respectively, difference was not significant（P>0.05）；the main infection site was lower respiratory tract（43.00%），followed by surgical site (16.43%); the risk factors for HAI were age ≥65 years, chronic systemic diseases(diabetes, cirrhosis, chronic renal failure, chronic lung disease), immunodeficiency（white blood cell<1.5×109/L), coma, tracheotomy, and mechanical ventilation. ConclusionSurvey on HAI prevalence can promote continuous improvement of HAI management, surveillance on surgical site infection and risk factors of HAI should be strengthened.