某医院2013年医院感染现患率调查及影响因素分析

目的了解所在医院医院感染现患情况,为医院感染防控提供依据。方法采用床旁调查与查阅病历相结合的方法,对2013年7月19日00 00-24 00所有住院患者的医院感染情况进行调查分析。结果应查人数1 828例,实查1 815例,实查率为99.29%。发生医院感染55例（55例次）,医院感染现患率和例次现患率均为3.03%。现患率居前3位的科室依次为：重症监护综合病房（37.50%）、神经外科一（13.73%）及神经外科二（12.00%）;感染部位最多的是下呼吸道感染（占45.45%）;医院感染患者病原学送检率为38.18%（21/55）,其中金黄色葡萄球菌6例（28.57%）、铜绿假单胞菌5例（23.81%）、肺炎克雷伯菌3例（14.29%）、鲍曼不动杆菌2例（9.52%）;抗菌药物使用率24.08%,其中治疗用药占75.29%;性别、是否手术、有无泌尿道插管、动静脉插管、气管切开、使用呼吸机、血液透析、是否使用抗菌药物等因素为影响医院感染发生的主要因素。结论医院感染现患率调查有助于全面了解医院感染现状,有利于针对性地开展监测,更好地指导医院感染防控工作。

A Survey of Nosocomial Infection Rate in a Hospital in 2013 and Analysis of the Influence Factors

Objective To investigate the prevalence of nosocomial infection in a hospital and to provide a basis for hospital infection control. Methods Using bedside investigation and medical records analysis, we surveyed all hospitalized patients from 00：00 to 24：00 on July 19th, 2013. Results The real investigation was carried out on 1 815 patients out of all the 1 828 patients with a real investigation rate of 99.29%. There were 55 cases of nosocomial infection （55 ease-times）, and both the nosoeomial point infection rate and ease-time infection rate were 3.03%. The top three departments with the highest rate were Intensive Care Unit （37.50%）, Neurosurgery Department One （13.73%） and Neurosurgery Department Two （12.00%）. Most infections occurred on the lower respiratory tract, which accounted for 45.45%. Nosocomial infection pathogenic detection rate was 38.18% （21/55）： 6 cases of Staphylococcus aureus （28.57%）, 5 of Pseudomonas aeruginosa （23.81%）, 3 of Klebsiella pneumoniae （14.29%）, and 2 cases ofAcinetobacter baumanii （9.52%）. The rate of antimicrobial drug use was 24.08%, in which drug treatment accounted for 75.29%. Gender, surgery, urinary catheter, vascular catheter, tracheostomy, ventilator application, hemodialysis, and use of antibiotics were all influential factors for occurrence of nosoeomial infection. Conclusion Nosocomial infection prevalence survey can help fully understand the status of hospital infection, help to carry out targeted surveillance, and better guidance for hospital to prevent and control nosoeomial infection.