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。

Cross-sectional survey on prevalence of nosocomial infections among 65885 hospitalized patients in Guizhou province in 2014

Abstract: Objective The aim of this study was to study the status of prevalence rates of nosocomial infections in Guizhou, and to improve infection control awareness and provide scientific basis of nosocomial infections. Methods One hundred and seventy-four hospitals of Guizhou province participated in NI prevalence survey from September 1st to 30th, 2014. Hospitals were surveyed for a given day (0:00-24:00) decided by each hospital. Point prevalence of NI among all hospitalized patients were investigated by combination of bed-visiting and medical records checking. Results 99.66% (65885/66111) of the patients were checked. One thousand five hundred and forty-six patients had 1643 times of NI. NI rate and case rate were 2.35% (1546/65885) and 2.49% (1643/65885), respectively. NI prevalence rates of hospitals with different sizes were statistically different (χ2=56.35, P<0.01). The higher prevalence rate appeared in ICU (25.20%). The lower respiratory tract infection (40.35%) was the primary infection site. Gram-negative bacillus (70.37%) was the predominant pathogens in nosocomial infections. NI prevalence rates of hospitals with different departments, different sites, different pathogenic bacteria were statistically different (χ2=1209.54, P<0.01, χ2=1041.43, P<0.01, χ2=1167.40, P<0.01). Utilization ratio of antibacterial was 39.24% (25851/65885), of which 67.24% (17382/25851) were medication. Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 32.81% (25851/65885). Conclusion We should be more focused on intensive care unit, lower respiratory tract and Gram-negative bacteria, rationally usage of antibiotics and increase the rate of sample infection so as to reduce the nosocomial infections.