2014-2018年某三甲综合性医院医院感染现患率调查

摘要 目的 了解2014-2018年某三甲综合医院医院感染现状、医院感染部位、抗菌药物使用及病原学送检情况。方法 采取床旁调查和病历调查相结合的方法，选取2014年8月21日、2015年8月16日、2016年4月13日、2017年7月29日和2018年7月12日为调查日，对该院所有住院患者进行调查。结果 2014-2018年医院感染现患率分别为4.83%、4.46%、3.83%、4.66%和2.63%。医院感染现患率较高的科室为重症监护病房(ICU)，感染高发部位依次为下呼吸道、上呼吸道、泌尿道。5年中抗菌药物使用率分别为39.7%、39.18%、34.4%和36.6%、35.78%，以治疗为目的的抗菌药物细菌培养送检率依次为61.70%、53.40%、57.86%、60.03%和44.75%。检出病原菌主要为大肠埃希菌82株、肺炎克雷伯菌52株、铜绿假单胞菌46株。结论 该院医院感染科室以ICU为主，感染部位以下呼吸道最常见，检出病原菌以革兰阴性菌为主。

Investigation on the prevalence of nosocomial infection in a tertiary general hospital from 2014 to 2018

Objective To investigate the status of nosocomial infection,nosocomial infection sites,use of antibiotics and etiological examination in a tertiary general hospital from 2014 to 2018. Methods A combination of bedside survey and medical record survey was adopted,and the survey was conducted on August 21,2014,August 16,2015,April 13,2016,July29,2017 and July 12,2018 and all hospitalized patients in the hospital were investigated. Results The current prevalence of nosocomial infections from 2014 to 2018 were 4. 83%,4. 46%,3. 83%,4. 66%,and 2. 63% respectively. The department with higher prevalence of nosocomial infections was the intensive care unit( ICU),and the top three sites of infection were lower respiratory tract,upper respiratory tract,and urinary tract. The use rates of antibiotics in the past 5 years were39. 7%,39. 18%,34. 4%,36. 6%,and 35. 78%,respectively. The submission rate of bacterial culture of antibiotics for therapeutic purposes were 61. 70%,53. 40%,57. 86%,60. 03%,and 44. 75%,respectively. The detected pathogens were82 strains of Escherichia coli,52 strains of Klebsiella pneumoniae,and 46 strains of Pseudomonas aeruginosa.Conclusion ICU is the main infection department in this hospital,and the lower respiratory tract is the most common infection site and Gram-negative bacteria are the main detected pathogenic bacteria.