1999～2006年上海市某综合医院住院患者医院感染状况分析

[目的]探讨综合医院住院患者医院感染流行状况及流行趋势，为医院感染的预防和控制提供科学依据。[方法]采用回顾性和前瞻性相结合的方法对1999-2006年在我院住院的153703例住院患者进行医院感染监测，对其中发生医院感染的7320例患者进行调查分析。[结果]医院感染率4．76％，例次感染率5．03％。2004～2006年医院感染率4．09％低于1999-2003年的5．61％（P〈0．01）。科室例次感染率以ICU最高（15．89％），其次为内科（8．68％），儿科最低（0．01％）；科室感染例次构成比以内科最高（占74．02％），其次为外科（占21．07％），儿科最低（占0．54％）；各部位例次感染率，泌尿道由1．91％下降至0．61％（P〈0．01），手术部位由0．35％下降至0．21％（P〈0．01），下呼吸道由1．80％下降至1．23％（P〈0．01），其他部位感染由0．23％下降至0．14％（P〈0．01）；上呼吸道、胃肠道、腹腔内组织及血管相关感染的差异均无统计学意义（P〉0．05）。医院感染患者年龄分布以大于60岁所占比重最大（77．79％）。致病菌检出以G^-杆菌为主（占51．86％）。[结论]加强医院感染监测工作，针对本院医院感染流行特点及时采取预防措施，能有效控制医院感染的暴发流行、减少各种感染的危险因素、逐步降低医院感染发病率。

Epidemiological Analysis of Nosocomial Infection Cases in Hospital in shanghai City from 1999 to 2006

[Objective] To explore the epidemic situation and tendency of nosocomial infection cases in hospital,provide scientific basis for nosocomial infection prevention and control.[Methods]A total of 153 703 cases in Putuo hospital from 1999 to 2006 were investigated by backward and prospective study.The epidemic situation on 7 320 cases of nosocomial infection was compared and analyzed.[Results]The Incidence of hospital infection that calculated by the number of the patients and the cases were 4.76% and 5.03%,respectively.The incidence(4.09%)of hospital infection from 2004 to 2006 was lower than the rate(5.61%)from 1999 to 2003(P<0.01).The department that had the highest nosocomial infection was ICU(15.89%),the internal medicine(8.68%)ranked the next,while the lowest was pediatrics(0.01%).The most nosocomial infection cases in internal medicine accounted for 74.02%,the surgical(21.07%)ranked the next,while the lowest was pediatrics(0.54%).The prevalence rate of infection in urinary tract dropped from 1.91% to 0.61%(P<0.01),surgical site dropped from 0.35% to 0.21%(P<0.01),lower respiratory tract dropped from 1.80% to 1.23%(P<0.01),the infection of other parts dropped from 0.23% to 0.14%(P<0.01).There was no significant difference in the prevalence rate of infection among upper respiratory tract,gastrointestinal track,intra-abdominal cavity and blood vessel infection(P>0.05).77.79% of nosocomial infection cases were at the age over 60.Gramnegative bacilli were the dominant bacteria in the infections,accounting for 51.86%.[Conclusion]Nosocomial infection monitoring should be strengthened,preventive measure should be taken in order to control the prevalence of nosocomial infection effectively,risk factors of different infections can be reduced the incidence of hospital infection can be decreased.