2001～2010年我院医院感染的调查和长期趋势分析

目的分析广西壮族自治区人民医院2001～2010年医院感染的发病率、感染部位分布、病原体的长期趋势,为深入开展医院感染监测工作提供依据。方法采用前瞻性与目标性监测相结合的调查方法监测该院2001～2010年的所有住院患者,对医院感染确认病例进行统计分析。结果 2001～2010年医院感染的总发生率为3.39%(2007～2008年呈上升趋势,P0.01)。常见感染部位为下呼吸道、泌尿道、胃肠道、上呼吸道及皮肤软组织;呼吸系统的感染率呈下降趋势(P0.01),但是下呼吸道构成比从2001年的27.9%上升到2010年的43.18%;泌尿系统、血液系统、腹部和消化系统、手术部位的医院感染发生率均呈上升趋势(P0.01)。重症监护病房、神经外科、老年病房、血液内科、肿瘤科的医院感染发生率长期处于前列。常见病原体有不动杆菌属、白色念珠菌、其它真菌、铜绿假单胞菌、大肠埃希菌、克雷白菌属、金黄色葡萄球菌。结论通过长期趋势分析表明,该院医院感染的重点科室为重症监护病房、神经外科等、重点感染部位为呼吸道、泌尿道及胃肠道等,重点病原体为不动杆菌、白色含珠菌等。应有针对性地重点加强这些科室、部位和病原体的目标性监测。

Nosocomial infections in a provincial hospital:A 10-year prospective study(2001-2010)

Objective To study the incidence,constituent ratio and microbiology of nosocomial infections (NI) in the People’ s Hospital of Guangxi Zhuang Autonomous Region during 2001 ~ 2010.Methods Information on NI was collected prospectively by active surveillance.Results The overall incidence of NI was 3.39%,with a trend of increase during the study period.A significant increase in NI incidence was recorded during 2007 ~ 2008(P < 0.01).NI was most commonly found in the lower respiratory tract,followed by urinary tract,digestive tract,upper respiratory tract,skin and soft tissue.Though a significant decrease in NI incidence of respiratory system was recorded during the study period(P <0.01),the constituent ratio of lower respiratory tract infection showed an increase from 27.9%to 43.18%.A significant increase was recorded in NI incidence of urinary system,hematological system, abdomen and digestive system,and surgical sites(P < 0.01).The NI incidence was higher in departments of neurosurgery,gerontology,hematology and oncology than other hospital departments except the intensive care unit. Acinetobacter,Candida albicans and other fungi,Pseudomonad,Escherichia coli,Klebsiella and Staphylococcus aureus were the most frequently isolated infectious organisms.Conclusion We have identified the most common sites, departments and organisms involved in NI,which will facilitate effective monitoring and focused intervention to reduce NI in a large provincial hospital.