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目的了解某教学医院住院患者医院感染基本情况和变化趋势,为更有效地预防医院感染提供科学依据。方法采用现场与回顾性调查方法,对某教学医院近年3次医院感染现患率调查结果进行分析。结果 3次共调查住院患者11 928例,发生医院感染324例、342例次,医院感染现患率2.72%、例次感染率2.87%;2010、2012、2014年医院感染现患率分别为3.11%、2.78%和2.45%,差异无统计学意义;3次调查医院感染率最高的科室是综合ICU,为42.31%;感染部位以下呼吸道居首位,占55.56%。各年度调查当日抗菌药物使用率分别为55.30%、45.35%和37.39%,呈递减趋势。检出病原菌以革兰阴性菌为主,占63.46%;革兰阳性菌检出率为第二位,占22.97%;真菌感染占13.40%。结论该院住院患者医院感染现患率持续降低;做好综合ICU患者医院感染的预防控制、预防下呼吸道医院感染的发生及合理使用抗菌药物仍是现阶段医院感染控制工作的重点。
Objective To understand the basic situation and trend of nosocomial infection in inpatients in a teaching hospital and provide a scientific basis for more effective prevention of nosocomial infections. Methods By field and retrospective survey, the prevalence rate of hospital infection in three teaching hospitals in recent years was analyzed. Results A total of 11 928 hospitalized patients were investigated in 3 times. There were 324 cases of nosocomial infection and 342 cases of them. The prevalence rate of nosocomial infection was 2.72% and the rate of nosocomial infection was 2.87%. The prevalence rates of nosocomial infections in 2010, 2012 and 2014 were 3.11% 2.78% and 2.45%, respectively. There was no significant difference between them. In the three surveys, the department with the highest hospital infection rate was ICU, accounting for 42.31%. The respiratory tract below the infected site ranked the first with 55.56%. Antibiotics use rates on the survey day were 55.30%, 45.35% and 37.39%, respectively, showing a decreasing trend. Gram-negative bacteria were the main pathogens, accounting for 63.46%; Gram-positive bacteria was the second, accounting for 22.97%; fungal infection accounted for 13.40%. Conclusions The prevalence of nosocomial infections in this hospital keeps decreasing. Prevention and control of nosocomial infections in ICU patients, prevention of nosocomial infections in lower respiratory tract and the rational use of antimicrobial drugs are still the focus of hospital infection control.