2011年四川省248所医院医院感染横断面调查

目的了解四川省医疗机构2011年医院感染基本情况，建立医院感染相关指标的参照体系。方法2011年9月1-30日，四川省248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248所医院调查日（0∶00-24∶00）所有住院患者进行调查。结果248所医院应查人数75 822例，实查74 457例，实查率98.20%。发生医院感染1 966例，2 001例次，医院感染现患率为2.64%，例次现患率为2.69%。不同规模医院医院感染现患率比较，差异有统计学意义（χ2=46.70，P＜0.01），随着医院规模的增大，医院感染现患率升高。医院感染部位居前3位者依次为呼吸道(55.77%)、泌尿道(12.79%)和手术切口(11.99%)；医院感染现患率较高的科室依次为：肿瘤科（4.52%）、外科（3.28%）和内科（3.02%）；医院感染患者病原学送检率为42.13%（843/2 001）；调查当日共39 440例患者使用抗菌药物，医院抗菌药物使用率为52.97%，其中11 209例（15.05%）患者预防用药，28 231例（37.92%）患者治疗用药。医院治疗用抗菌药物者送细菌培养率为21.63%（6 105/28 231）。结论此次调查有助于了解四川省各医院医院感染的基本情况，建立各指标的参照体系，供各医院参考比对，可指导医院感染防控工作。

Cross sectional survey on healthcare associated infection in 248 hospitals of Sichuan province in 2011

Objective To investigate the prevalence of healthcare associated infection（HAI） in the healthcare settings of Sichuan province in 2011, and establish the reference system of HAI indicators.Methods248 hospitals of Sichuan province participated in HAI prevalence survey in September 1st 30th, 2011. Hospitals were surveyed for a given day（0∶00-24∶00）decided by each hospital, point prevalence of HAI among all hospitalized patients were investigated by combination of bed visiting and medical records checking.Results75 822 patients in 248 hospitals should be surveyed, 74 457 patients （98.20%）were actually surveyed. 1 966 patients had 2 001 times of HAI, HAI rate and case rate was 2.64% and 2.69% respectively; HAI prevalence rates of hospitals with different sizes were statistically different （X2=46.70,P〈0.01）, and HAI prevalence rate increased with the increase of hospital size. The top 3 HAI sites were respiratory tract （55.77%）, urinary tract （12.79%） and surgical site （11.99%）; HAI were high in oncology department（4.52%）, surgery department （3.28%） and internal medicine department （3.02%）; pathogenic detection rate of specimens from HAI patients was 42.13%（843/2 001）;39 440 patients used antimicrobial agents on the day of survey, antimicrobial usage rate was 52.97%, of which 15.05% （11 209 cases） were prophylactic and 37.92% （28 231） were therapeutic. Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 21.63%（6 105/28 231）.ConclusionThis prevalence survey is helpful for realizing the HAI state in healthcare settings of Sichuan province, and guide the prevention and control of HAI.