医院感染现患率调查分析

目的 了解医院住院患者医院感染现状及危险因素,为有效控制医院感染提供参考.方法 采用床旁调查与查阅病历相结合的横断面调查方法,对2011年7月19日的住院患者进行医院感染现患率调查.结果 实查住院患者1041例,医院感染60例、67例次,医院感染现患率为5.76％、例次感染率为6.44％;其中血液内科感染率最高,为22.22％;医院感染部位以下呼吸道感染居首位,占38.81％;抗菌药物的使用率为48.41％;医院感染病原菌以革兰阴性为主.结论 加强重点部门及高危人群的目标性监测,下呼吸道感染的预防与控制是今后工作的重点.     

现患率调查在医院感染管理中的应用

目的 了解某院住院患者医院感染与社区感染现状及抗菌药物使用情况.方法 采取床旁调查和查阅住院病历相结合的方法,于2010、2011年某日对1931例住院患者进行感染现患率及抗菌药物使用情况调查.结果 2010年与2011年医院感染现患率分别为4.90％与6.09％,医院感染现患例次率分别为5.12％与6.39％;社区感染现患率分别为21.27％与22.17％,社区例次感染率分别为21.38％与22.94％;医院与社区感染部位均以下呼吸道为主;感染病原体均以革兰阴性菌为主;两次调查中医院感染与社区感染现患率最高的科室分别均为ICU与儿科,抗菌药物日使用率2011年为37.85％低于2010年的44.77％,治疗用药病原学送检率2011年为61.86％,高于2010年的33.47％.结论 应重点监测医院感染高发科室,提高医务人员感染控制意识与水平,加强对抗菌药物合理应用的管理,以有效预防与控制医院感染.     

The prevalence of infections in psychiatric institutes in Belgium

To assess the prevalence of infections in psychiatric institutes in Belgium, a cross-sectional study was performed within a cluster sample of psychiatric patients from 29 psychiatric institutes (about 40% of all Belgian psychiatric institutes). During May 1992, 8679 patients were analysed. Of the study population 59% were men. The mean age ±SD was 54·5 ± 18·3 years, with a median of 55 years. The mean hospitalization period was 9·6 ± 14·5 years with a median of 2 years. A total of 1334 infections were reported, and 13·1% of the patients had at least one infection (95% CI: 12·4–13·8%) at the time of the study. The most common infections were dermatological infections (31·6%), lower respiratory tract infections (25·8%), urinary tract infections (12·4%) and conjunctivitis (11·6%). Statistically significant associations with infection prevalence were found with age, psychiatric diagnosis, activity of daily living score, the duration of hospitalization, and the qualification of the person answering the survey form. The relevance and the limitations of this study are discussed.     

The first prevalence survey of nosocomial infections in the University Hospital Centre 'Mother Teresa' of Tirana, Albania

A survey was conducted in the largest hospital in Albania to estimate the prevalence and risk factors for nosocomial infections (NIs). A one-day prevalence survey was carried out between October and November 2003 in medical, surgical and intensive care wards. Centers for Disease Control and Prevention definitions were used. Study variables included patient and hospital characteristics, surgical procedures, invasive devices, antibiotic treatment, microbiological and radiological examinations, infection signs and symptoms. Risk factors were determined using logistic regression. In all, 185 NIs were found in 163 of 968 enrolled patients. Urinary tract infections (33.0%), surgical site infections (24.3%), pneumonia (13.0%) and venous infections (9.2%) were the most frequent NIs. The prevalence of NIs was higher in intensive care units (31.6%) than in surgical (22.0%) and medical wards (10.3%). Overall, 132 NIs (71.4%) were confirmed by microbiological examination; the single most frequently isolated micro-organism was Staphylococcus aureus (18.2%). By means of logistic regression, the following independent risk factors were identified: age >40 years, length of hospital stay, 'trauma' diagnosis at admission, and invasive devices. Even though comparisons must be made with great caution, the prevalence of NIs was higher than in western European countries and in some developing countries.     

Healthcare-associated infections in Finnish acute care hospitals: a national prevalence survey, 2005

The objectives of the first national prevalence survey on healthcare-associated infections (HAIs) in Finland were to assess the extent of HAI, distribution of HAI types, causative organisms, prevalence of predisposing factors and use of antimicrobial agents. The voluntary survey was performed during February-March 2005 in 30 hospitals, including tertiary and secondary care hospitals and 10 (25%) other acute care hospitals in the country. The overall prevalence of HAI was 8.5% (703/8234). Surgical site infection was the most common HAI (29%), followed by urinary tract infection (19%) and primary bloodstream infection or clinical sepsis (17%). HAI prevalence was higher in males, among intensive care and surgical patients, and increased with age and severity of underlying illness. The most common causative organisms, identified in 56% (398/703) of patients with HAIs, were Escherichia coli (13%), Staphylococcus aureus (10%) and Enterococcus faecalis (9%). HAIs caused by multi-resistant microbes were rare (N = 6). A total of 122 patients were treated in contact isolation due to the carriage of multi-resistant microbes. At the time of the survey, 19% of patients had a urinary catheter, 6% central venous line and 1% were ventilated. Antimicrobial treatment was given to 39% of patients. These results can be used for prioritising infection control measures and planning more detailed incidence surveillance of HAI. The survey was a useful tool to increase the awareness of HAI in participating hospitals and to train infection control staff in diagnosing HAIs.     

Microbiological aspects of the 1980 national prevalence survey of infections in hospitals

The records of the 1980 national prevalence survey of infection in hospitals were re-assessed from a microbiological point of view. Of 407 records of Escherichia coli, 71 per cent came from the urinary tract while the commonest source of Staphylococcus aureus was from skin infections. These yielded only 41 per cent of the 303 records. Proteus spp. were recorded 166 times, Pseudomonas spp. 115 times and Klebsiella spp. 101 times. These came mainly from the urinary tract but other sources were important. Streptococcus pneumonias, Haemophilus influenzae, Mycobacterium tuberculosis and the viruses were associated with community infections while E. coli, Proteus spp., Pseudomonas spp., Klebsiella spp., Str. faecalis and non-aureus staphylococci were associated with hospital-acquired infections. The prevalence of bacteraemia was re-assessed.     

综合医院4年医院感染横断面调查分析

目的了解某综合医院医院感染基本情况、抗菌药物使用现状及治疗性应用抗菌药物病原学检测,更好的控制医院感染及合理使用抗菌药物提供科学依据。方法调查2010-2013年连续4年的横断面调查日共应调查住院患者为3 775例,实际调查住院患者为3 729例,由感染监控部专职人员将调查数据录入"医院感染监测及数据直报系统"进行核对、汇总、整理、统计、分析并上报。结果 2010-2013年某综合医院感染现患率分别为3.05%、1.72%、2.33%、1.03%;抗菌药物使用率分别为42.76%、20.51%、21.09%、26.08%;一联用药使用率分别为81.22%、90.27%、93.25%、91.70%;二联用药使用率分别为17.99%、9.73%、6.75%、8.30%;三联用药使用率由0.79%降为0;治疗用药病原学送检率分别为24.15%、71.53%、81.62%、81.78%。结论医院感染现患率结果符合国家卫计委<10.00%的要求,通过每年的横断面调查日比较,反映了医院感染现患率、抗菌药物使用率及病原学送检率,更有利于开展细菌耐药性监测工作。     

The prevalence survey of nosocomial infections: a very informative tool in a big hospital setting

In November 2001 a one-day prevalence survey of nosocomial infections (NI) was conducted in surgical and intensive care units at two hospitals in Rome. The main goal was to quantify the occurrence of NI and of some patient-care practices, such as antibiotic use. The following NI were studied: pneumonia, bloodstream infections, urinary tract infections, surgical site infections (SSI), central line-related local infections. A total of 517 patients were included. The prevalence of the above mentioned NI was 6.6%. SSI were the most frequent NI (50%), with a prevalence of 6.5% in patients who underwent surgery; the SSI prevalence was 4.7% in clean surgical procedures (SP) and 5.6% in clean-contaminated SP. In 29 NI, 33 micro-organisms were isolated; the most frequent (24.3%) was Staphylococcus aureus, which was methicillin-resistant (MRSA) in 75% of the strains. On the day of the study, 41.8% of the patients were treated with antimicrobials, mainly aminopenicillins and third generation cephalosporins. In 31.8% of cases antibiotics were given for surgical prophylaxis; patients received prophylactic antibiotics more than 2 hours prior the initial incision in almost 40% of clean SP and 60% of clean-contaminated SP. In our hospitals prevalence survey was a very useful tool to identify the following priorities: SSI prospective surveillance in clean and clean-contaminated SP, control of MRSA selection and transmission, guidelines for antimicrobial prophylaxis in surgery.     

医院感染现患率调查研究

目的 了解医院感染现状,为采取针对性的医院感染管理措施提供依据.方法 采用横断面调查的方法,采用病历调查与床旁调查相结合的模式,对2011年6月25日住院患者进行医院感染调查.结果 共调查1035例患者,医院感染率为5.31％;感染率较高的科室为ICU 30.00％、儿科19.15％、新生儿室14.29％和神经外科11.36％;下呼吸道为主要感染部位,占49.23％;呼吸机相关性肺部感染率为34.12％,中心静脉导管相关性血流感染率为2.38％,泌尿道插管相关性泌尿道感染率为1.59％;病原学培养送检率为45.45％,主要病原菌为鲍氏不动杆菌和铜绿假单胞菌;调查当日抗菌药物使用率46.18％;治疗用药物送细菌培养率27.76％;使用频度前10位的抗菌药物30.00％为医院常规药敏试验品种,50.00％为作用、性质近似品.结论 医院感染日常监测中部分科室存在漏报现象;ICU、儿科、新生儿室为医院感染重点监测部门;应采取综合措施降低呼吸机、中心静脉置管、泌尿道置管等侵入性操作所致医院感染;医院常规药敏试验品种应根据临床药物使用情况及时调整,应加强医院感染病例和治疗用药的细菌学检查.     

医院感染横断面调查与分析

目的 了解医院感染的现状和横断面抗菌药物使用情况.方法 采用横断面调查方法,床边与病历调查相结合,对2012年11月23日的医院感染现患率进行调查.结果 调查住院患者906例,医院感染28例、30例次,医院感染现患率3.09％、例次感染率3.31％;呼吸道、泌尿道、胃肠道为医院常见的感染部位;肾内科、神经外科、综合ICU为感染高危科室;抗菌药物当天使用率为42.60％,一联用药61.92％,二联用药38.08％.结论 通过调查结果,可以有针对性地开展目标性监测,采取预防控制措施;正确、合理地使用抗菌药物,有效降低医院感染率.     

医院感染横断面调查分析

目的分析医院感染现患率,结合感染部位、抗菌药物使用情况及相关危险因素,为改进监控措施提供有力依据。方法按照全军医院感染监测中心制定的调查方案,采取床旁调查与病历调查相结合的方法,对2014年12月17日0∶00-24∶00所有住院患者进行医院感染横断面调查。结果共调查住院患者936例,发生医院感染33例、36例次,医院感染现患率为3.53%,例次感染率为3.85%,内科系统感染率前3位科室分别为ICU、血液移植科和神经内科,感染率依次为15.00%、12.50%、8.90%;外科系统感染率前3位科室分别为神经外科、烧伤科、血管神经外科,感染率依次为15.00%、12.50%、6.90%;急诊科也较高,感染率为13.33%;呼吸系统、泌尿系统和血液系统为主要感染部位,分别占58.33%、22.22%、8.33%;检出病原菌31株,其中革兰阴性菌占58.06%、革兰阳性菌占22.58%、真菌占19.35%。结论应有效落实感染控制措施,加强对重点科室、重点人群的目标监测,减少侵入性操作,合理使用抗菌药物,以减少医院感染的发生。     

医院感染现患率调查

目的 了解住院患者医院感染的状况及其影响因素,为有效控制医院感染提供科学依据.方法 采用横断面调查方法,即床旁走访和查阅病历相结合,按医院感染病例登记表逐项记录,统一汇总.结果 实查住院患者551例,发现医院感染27例、30例次,现患率为4.90％、例次感染率为5.44％；以下呼吸道感染居首位,占44.44％；革兰阴性杆菌是主要的医院感染致病菌,抗菌药物的应用率为71.51％,呼吸内科和儿科的治疗用药,心内科和消化内科的介入检查治疗、眼科和外科系统的手术预防用药居高不下,＞96.97％,主要存在着用药指征不严、起点高、时间长和联合不当等不合理情况.结论根据现患率的调查,应针对性地开展目标性监测,采取有效的预防控制措施,规范抗菌药物的合理应用,切实降低医院感染的发生率.     

医院感染现患率调查研究

目的探讨某三级甲等医院近5年医院感染状况,为临床预防治疗提供参考依据。方法采用横断面调查2011-2015年每年2月1日内的所有住院患者医院感染现患率,数据采用SPSS 17.0软件进行统计分析。结果 5年共调查5 626例患者,发生医院感染现患率逐年降低,从2011年的6.10%下降至2015年的2.53%,差异统计学有意义(P<0.05);其中医院感染现患率最高的为ICU,其次为烧伤科和泌尿外科;医院感染发生部位主要为下呼吸道,其次为泌尿道,感染发生率较低的为抗生素相关性腹泻、腹水感染;5年内各科室抗菌药物使用率逐年降低,差异有统计学意义(P<0.05),其中普通外科、泌尿外科、骨科、心胸外科、烧伤科、神经外科、妇产科、ICU、五官科、儿科、呼吸内科抗菌药物的使用率较高。结论近5年内医院感染现患率和各科室抗菌药物使用率逐渐降低,医院感染发生部位主要为下呼吸道和泌尿道,因而在临床中应当加强对呼吸道和泌尿道的监管,合理使用抗菌药物,预防医院感染的发生。     

2014年贵州省65885例住院患者医院感染横断面调查

摘要:目的　了解贵州省医院感染现状,为进一步预防和控制医院感染提供科学依据。方法　2014年９月5-30日,贵州省174所二级及二级以上医院参与医院感染现患率调查。参与调查的各医院自行确定调查日,采取床旁调查和查阅住院病历相结合的方法,对参与调查医院调查日（0:00-24:00）的所有住院患者进行调查。结果　医院感染横断面调查实查率99.66%（65885/66111）,发生医院感染1546例,1643例次,医院感染现患率为2.35％（1546/65885）,例次现患率为2.49％（1643/65885）。不同规模医院医院感染现患率比较,差异有统计学意义（χ2＝56.35,P＜0.01）;重症医学科（25.20%）为医院感染高发科室;感染部位以下呼吸道（40.35%）为主;革兰阴性菌（70.37%）位居医院感染病原菌首位,不同科室、感染部位、病原菌的医院感染现患率比较,差异均有统计学意义（χ2＝1209.54,P＜0.01,χ2＝1041.43,P＜0.01,χ2＝1167.40,P＜0.01）;调查当日抗菌药物使用率为39.24%（25851/65885）,治疗用药为主占67.24％（17382/25851）;治疗使用抗菌药物者病原菌培养送检率为32.81%（25851/65885）。结论　重点监控ICU,呼吸道感染和革兰氏阴性杆菌,合理使用抗菌药物,提高病原菌送检率从而降低医院感染风险。     

How to survey nosocomial infections.

Many surveillance methods for nosocomial infections (NIs) have been put forward in the literature, and all have their advantages and disadvantages. Different surveillance methods are useful, depending on whether the objective of surveillance is only to increase sensitivity to infection control problems and to identify areas with possible infection control problems; to confirm a possible infection control problem through comparison with other units or departments; or to use surveillance data for identifying the sources of infections. Furthermore, time effectiveness is a major point in selecting the most appropriate method, particularly the method for case identification. In units or departments with a high level of NI, even highly time-consuming surveillance methods may be ultimately time-effective; in units or departments with a lower level of NI, the time-effectiveness depends on the time necessary for case identification. Close liaison with staff in the units is a sine qua non for the success of all surveillance activities.     

2010年医院感染横断面调查分析

目的了解医院感染现患率及抗菌药物使用现状。方法按2010年"全国医院感染横断面调查计划书"要求,调查医院10月7日0∶00-24∶00所有住院患者;采用频数、率和构成比描述调查结果。结果应调查1462例,实际调查1433例,实查率98.02%;医院感染现患率为5.30%,感染部位主要为下呼吸道感染;抗菌药物使用率为47.5%,预防性用药比例占抗菌药物使用的50.1%。结论医院感染现患率与国内综合医院相当,下呼吸道感染和革兰阴性菌感染的预防控制及预防性用药的管理是今后医院感染工作的重点。     

Excel软件在医院感染现患率调查统计中的应用

目的 以最少的人力快速、准确地统计卫生部医院感染监控网统一格式的医院感染现患率调查汇总表。方法 建立Excel工作簿(数据库)，将要求上报的6份表格的字段全部列入，并逐项录入，进行数据筛选统计分析。结果 统计汇总工作省时、省力、准确；操作简单易学，非计算机专业人员也能运用自如。结论 尚未开展医院感染计算机管理的医院(300张床位以上)，应尽快开展计算机管理，除了使用医院感染管理专业软件外，可使用Excel解决专业软件中缺项的统计工作，提高工作效率。     

一级医疗机构医院感染现患率调查误差分析与改进对策

目的分析与探讨宝山区一级医疗机构医院感染现患率调查中存在的误差并提出相应对策。方法组织9所设有住院病房的一级医疗机构,对其2017年12月12日所有住院患者进行医院感染现患率调查。并于2018年3月对医院上报的数据进行复核。将上报数据与复核数据进行比较,分析产生误差的原因,并提出解决方法。结果实际调查住院患者379例,实查率为100.00%;复核病例379例,复核率为100.00%。通过数据比对,上报数据中医院感染病例12例,现患率为3.17%,复核数据中医院感染病例26例,现患率为6.86%,医院感染病例漏报率为53.85%(14/26);上报数据中抗菌药物使用率为5.54%(21/379),复核数据中抗菌药物使用率为9.50%(36/379),抗菌药物使用病例漏报率为41.67%(15/36);病原学送检率偏低为8.33%(3/36)。结论发现一级医疗机构医院感染现患率调查中存在漏报,应采取有针对性的改进对策,推进医院感染现患率调查在一级医疗机构应用普及。