2022年贵州省186所医疗机构医院感染横断面调查报告

Cross-sectional survey on healthcare-associated infection in 186 medical institutions in Guizhou Province in 2022

摘要:

目的 描述贵州地区医疗机构医院感染现状。 方法 采用横断面调查的方法, 于2022年7月15日—12月31日对贵州省186所医疗机构患者进行医院感染现患率调查。 结果 共调查住院患者89 409例, 发生医院感染1 066例, 医院感染现患率为1.19%, 其中贵阳市最高(1.38%), 毕节市最低(0.77%)。医院感染部位中, 下呼吸道占比最大(38.96%), 其次为泌尿道(14.42%)、皮肤软组织(8.00%)。医院感染现患例次率最高的科室是综合ICU, 达11.39%, 其次是血液病科(6.68%)和神经外科(4.83%)。医院感染病原体以革兰阴性菌为主, 占比高达66.79%。抗菌药物使用率为36.06%。Ⅰ类切口手术患者中, 医院感染现患率高达3.30%, 抗菌药物使用率为20.87%。不同床位数医疗机构抗菌药物使用率、Ⅰ类切口手术患者医院感染现患率和抗菌药物预防使用率比较, 差异均有统计学意义(χ²值分别为250.218、16.454、99.891, 均P＜0.01)。 结论 需加强对贵阳市和毕节市医院感染防控工作的管理, 以及对综合ICU及大规模医疗机构Ⅰ类切口手术部位感染的目标监测及感染控制。

Abstract:

Objective To describe the current status of healthcare-associated infection (HAI) in medical institutions (MIs) in Guizhou Province. Methods A cross-sectional survey was conducted to investigate the prevalence rates of HAI in 186 MIs in Guizhou Province from July 15 to December 31, 2022. Results A total of 89 409 hospitalized patients were surveyed, with 1 066 cases of HAI. The prevalence rate of HAI was 1.19%, with Guiyang City having the highest HAI rate (1.38%) and Bijie City having the lowest (0.77%). Among HAI sites, the proportion of lower respiratory tract was the highest (38.96%), followed by urinary tract (14.42%) and skin soft tissue (8.00%). The department with the highest prevalence rate of HAI was general intensive care unit (11.39%), followed by department of hematology (6.68%) and department of neurosurgery (4.83%). The main pathogens of HAI was Gram-negative bacteria, accounting for 66.79%. The usage rate of antimicrobial agents was 36.06%. Among patients underwent class Ⅰ incision surgery, the prevalence rate of HAI was 3.30%, and the usage rate of antimicrobial agents was 20.87%. There were statistically significant differences in the usage rate of antimicrobial agents, the HAI prevalence rate of patients who underwent class Ⅰ incision surgery, and the preventive usage rate of antimicrobial agents in patients in MIs with different bed numbers(χ²=250.218, 16.454, 99.891, respectively all P < 0.01). Conclusion It is necessary to strengthen the management of infection prevention and control in hospitals in Guiyang and Bijie Cities, as well as target monitoring and infection control on surgical site infection of class Ⅰ incision surgery in general ICUs and large-scale MIs.