2016-2018年高原地区某三甲医院医院感染现患率调查

目的 了解某院2016—2018年医院感染现患率及其变化趋势，评价医院感染管理控制措施的效果，为提高医院感染管理水平提供参考依据。方法 采用横断面调查方法，床旁调查与查阅病历相结合对该院2016年11月24日、2017年4月27日、2018年5月23日当天的所有住院患者进行医院感染现患率调查。结果 三年共调查患者790例，发现医院感染12例、13例次，医院感染现患率、例次现患率分别为1.52%、1.65%；各年份医院感染现患率分别为1.84%、1.43%、1.36%，三年之间比较差异无统计学意义（χ²=0.208，P=0.935）。医院感染部位以下呼吸道为主（占46.16%）。调查日抗菌药物使用率为53.67%，抗菌药物使用率从2016年的69.12%下降至2018年的37.07%，差异有统计学意义（χ²=57.554，P<0.001）。治疗性使用抗菌药物占70.91%~79.33%，一联使用抗菌药物占73.33%~80.73%，治疗性使用抗菌药物送细菌培养率从2017年的38.85%提高至2018年的59.30%，各年度抗菌药物使用目的、联用情况以及治疗性使用抗菌药物细菌培养送检情况比较，差异均有统计学意义（χ²值分别为62.266，、69.774、8.930，均P<0.05）。结论 该院近3年医院感染现患率无明显变化，抗菌药物使用逐年规范，但治疗性使用抗菌药物细菌培养送检率仍有待提高。

Prevalence rate of healthcare-associated infection in a tertiary first-class hospital in the plateau region from 2016 to 2018

Objective To understand the prevalence rate and changing trend of healthcare-associated infection(HAI) in a hospital from 2016 to 2018, and evaluate the effect of HAI management and control measures, so as to provide reference for improving HAI management level. Methods A cross-sectional survey was conducted through combination of bed-side investigation and medical record reviewing, prevalence of HAI among all inpatients in a hospital on November 24, 2016, April 27, 2017, and May 23, 2018 were investigated. Results A total of 790 patients were surveyed during three years, 12 patients had 13 cases of HAI, HAI rate and HAI case rate were 1.52% and 1.65% respectively;HAI prevalence rates of each year were 1.84%, 1.43%, and 1.36% respectively, difference was not significant (χ²=0.208,P=0.935); the main HAI site was lower respiratory tract (46.16%). The utilization rate of antimicrobial agents in the survey day was 53.67%, utilization rate of antimicrobial agents decreased from 69.12% in 2016 to 37.07% in 2018, difference was significant (χ²=57.554,P<0.001). Therapeutic use of antimicrobial agents accounted for 70.91%-79.33%, antimicrobial single use accounted for 73.33%-80.73%, bacterial culture rate for therapeutic use of antimicrobial agents increased from 38.85% in 2017 to 59.30% in 2018, there were significant differences in antimicrobial use purpose, combined antimicrobial use and bacterial culture for therapeutic antimicrobial use in each year (χ²=62.266, 69.774, 8.930, respectively, all P<0.05). Conclusion The prevalence of HAI has not changed significantly in the past three years, antimicrobial use has been standardized year by year, but bacterial culture rate for therapeutic antimicrobial use still needs to be improved.