某三甲医院2014—2018年医院感染现患率调查

目的 了解医院感染的实际情况及变化趋势，分析医院感染的危险因素。方法 选取某三级甲等医院，采用横断面调查方法，2014-2018年每年调查一次，调查期为1日，调查对象为当日全部在院和出院患者，统计分析5年医院感染资料。结果 共调查患者9 718例，医院感染现患率为4.55%，例次现患率为5.01%，五年医院感染现患率及例次现患率均呈逐年下降趋势，差异均有统计学意义（均P<0.001）。医院感染部位以下呼吸道为主，193例次，占39.63%，其次分别为手术部位（75例次，15.40%）、泌尿道（65例次，13.35%）和上呼吸道（29例次，5.95%）。医院感染现患率最高的科室为血液科（15.73%），例次现患率最高的为重症监护病房（16.72%）。共检出医院感染病原体414株，其中革兰阴性菌258株，革兰阳性菌112株，真菌38株，其他病原体6株。最常见的病原体为铜绿假单胞菌（51株），其次为大肠埃希菌（49株）、鲍曼不动杆菌（43株）、金黄色葡萄球菌（43株）和肺炎克雷伯菌（42株）。结论 医院感染现患率调查有助于了解医院感染发生情况，器械相关感染和手术部位感染是医院感染防控的重点。

Prevalence of healthcare-associated infection in a tertiary first-class hospital from 2014 to 2018

Objective To understand the actual situation and changing trend of healthcare-associated infection(HAI), and analyze the risk factors for HAI. Methods A cross-sectional survey was carried out in a tertiary first-class hospital each year from 2014 to 2018, the survey period was one day, all patients in hospital and discharged on that day were investigated, data of HAI in five years were statistically analyzed. Results A total of 9 718 patients were investigated, prevalence rates of HAI and HAI cases were 4.55% and 5.01% respectively, prevalence rates of HAI and HAI cases decreased year by year in five years, differences were all statistically significant (all P<0.001). Lower respiratory tract was the main infection site(n=193, 39.63%), followed by surgical site (n=75, 15.40%), urinary tract (n=65, 13.35%) and upper respiratory tract (n=29, 5.95%). Department of hematology had the highest prevalence rate of HAI (15.73%), intensive care unit had the highest prevalence rate of HAI cases (16.72%). A total of 414 pathogens were isolated from patients with HAI, including 258 strains of gram-negative bacteria, 112 gram-positive bacteria, 38 fungi and 6 other pathogens. The most common pathogens were Pseudomonas aeruginosa (51 strains), followed by Escherichia coli (49 strains), Acinetobacter baumannii (43 strains), Staphylococcus aureus (43 strains) and Klebsiella pneumoniae (42 strains). Conclusion Investigation on prevalence of HAI is conducive to understanding the incidence of HAI, prevention and control of HAI are the key points of device-related infection and surgical site infection.