摘要
目的全面了解某地区医院感染现状,对不同规模医院感染控制情况进行调查与分析。方法采用横断面调查方法,全市统一培训调查人员及调查方法,采取床旁调查与在架病历调查相结合,并在规定时间内完成各医院的调查,调查结果进行统计分析。结果共有64所医院参与调查,调查住院患者21 242例,医院感染628例、689例次,现患率2.96%、例次感染率3.24%;医院感染病原菌以革兰阴性菌为主;医院感染部位以下呼吸道居首,占38.32%,其余依次为皮肤和软组织、泌尿系统、上呼吸道、手术部位,分别占14.80%、11.32%、11.18%、8.42%;共分离出病原菌333株,检出率为48.33%,排名前5位的病原菌依次为铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌,分别占18.92%、13.21%、12.91%、12.01%、9.91%,其中分离出多药耐药菌213株,产ESBLs革兰阴性杆菌约占28.0%;不同规模医院的抗菌药物使用均以治疗性用药和一联用药为主,送检率平均为45.52%。结论不同规模医院感染控制情况有所差异,要加强医院感染控制整体水平;多药耐药菌株的检出需引起高度重视。
OBJECTIVE To fully understand the current status of nosocomial infections in a region and investigate the situation of infection control in different scales of hospitals. METHODS By means of cross-sectional investigation, the investigation approaches were formulated to train the investigators uniformly, the survey of the hospitals was completed within a stipulated time bY the means of bedside investigation combined with medical records review, then the statistical analysis of the results was performed. RESULTS Among the totally of 21 242 cases of patients from 64 hospitals, the nosocomial infections occurred in 628 （689 case-times） cases with the prevalence rate of 2.96% and the case-time infection rate of 3.24%. The gram-negative bacteria were the predominant pathogens causing nosocomial infections. Among the patients with nosocomial infections, the patients with lower respiratory tract infections accounted for 38.32 %, folowed by the cases with skin and soft tissue infections （14.80 %）, the cases with urinary tract infections （11. 32%）, the cases with upper respiratory tract infections （11.18%）, and the cases with surgical site infections （8.42%）. Of totally 689 case-times of patients with infections, there were 333 strains of pathogens isolated with the detection rate of 48. 33%; the Pseudomonas aeruginosa （18. 92%）, Staphylococcus aureus （13. 21%） , Escherichia coli （ 12. 91%）, Acinetobacter baumannii （12. 01%）, and Klebsiella pneumoniae （9.91% ） ranked the top 5 species of pathogens, among which there were 213 isolates of multidrug-resistant bacteria, and the ESBLs-produeing gram-negative bacteria accounted for 28. 0%. The therapeutic medication and one-drug medication were dominant among the different scales of hospitals, with the average submission rate of 45.52 %. CONCLUSION The different scales of hospitals vary in the control of nosocomial infections, it is necessary to improve the overall level of nosocomial infection control and pay high attention to the detection of multidrug-resistant bacteria.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第21期5143-5145,共3页
Chinese Journal of Nosocomiology
基金
深圳市科技和信息局科技基金资助项目(201102088)
关键词
医院感染
横断面调查
分析
Nosocomial infection
Cross-sectional survey
Analysis
