2016-2018年医院感染和社区感染现患率调查分析

摘要 目的 〖JP2〗了解医院感染和社区感染现患率及其分布情况，为提高感染管理水平提供参考依据。方法 采用横断面调查方法，对2016-2018年住院患者进行感染现患率调查，分析不同科室、年龄现患率和感染部位及病原菌分布情况。结果 3年共调查7 446例患者，医院感染现患率3.64%，社区感染现患率24.79%，3年现患率比较，差异无统计学意义(P＞0.05)；感染现患率前3位的科室为ICU、神经外科ICU及神经内科ICU，社区感染现患率前3位的为呼吸内科、儿科及泌尿外科；不同年龄医院感染和社区感染现患率均呈“U”型分布；感染部位均以下呼吸道为主；病原菌均以革兰阴性菌为主，铜绿假单胞菌、鲍曼不动杆菌和克雷伯菌属等医院感染构成比高于相应社区感染构成比，大肠埃希菌、金黄色葡萄球菌及肠球菌属等社区感染构成比高于相应医院感染构成比。结论 现患率调查可发现医院感染和社区感染的异同点，有利于加强重点科室、高危人群、重点部位及重点病原菌的感染防控。〖JP〗

Investigation and analysis on the prevalence of nosocomial infection and community infection from 2016 to 2018

Objective To understand the prevalence and distribution of nosocomial infection and community infection,so as to provide reference for improving the level of infection management. Methods The prevalence of infection was investigated by cross-sectional survey among inpatients from 2016 to 2018. The prevalence of infection in different departments and ages and the distribution of infection sites and pathogenic bacteria were analyzed. Results A total of 7 446 inpatients were actually investigated in 3 years,with the nosocomial infection rate of 3. 64% and the community infection rate of 24. 79%. There was no significant difference in the 3-year prevalence rates( P > 0. 05). The top three departments of prevalence rate of nosocomial infection were ICU,neurosurgery ICU and neurology ICU,while the top three departments of prevalence rate of community infection were respiratory medicine,pediatrics and urology. The prevalence rate of nosocomial infection and community infection was U-shaped distribution in different ages. The infection sites were mainly lower respiratory tract. Gram-negative bacteria were the main pathogens. The proportion of nosocomial infection of Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella was higher than the corresponding proportion of community infection,while the proportion of community infection of Escherichia coli,Staphylococcus aureus and Enterococcus was higher than the corresponding proportion of nosocomial infection. Conclusion The investigation of the prevalence rate can find the similarities and differences between nosocomial infection and community infections,which is helpful to strengthen the prevention and control of infection in key departments,high-risk groups,key parts and key pathogens.