2017年某三级综合医院院内感染现患率横断面调查分析

目的 了解医院院内感染基本情况及现状,评估医院感染排名前3位科室的相关危险因素,为防控医院感染提供依据。方法采取院感监测软件与医院感染专职人员核查相结合的方法,对2017年11月15日0:00—24:00马鞍山市人民医院所有住院病人进行调查。结果 应查住院病人1 152例,实查1 152例,实查率100.00%。发生医院感染17例,现患率1.48%；发生医院感染18例次,例次感染率1.56%；医院感染部位以下呼吸道感染为主8例次,占44.44%；调查当日共分离病原体11株,居前3位的分别是:肺炎克雷伯菌3株(27.27%)、大肠埃希菌2株(18.18%)、白念珠菌2株(18.18%)；医院感染例次数居前3位的科室是:胸心外科(4例次)、外三科(3例次)、并列第三为重症医学科(2例次)和泌尿外科(2例次)；当日输液1 048例,占90.97%；当日使用抗菌药物306例,抗菌药物使用率26.56%；治疗用药例数282例,送检172例,治疗用药送检率60.99%。结论 自2016年使用院感软件对全院实时监控以来,杜绝了医院感染漏报,医院感染现患率控制在较低水平。应加强对重点部位、重点环节、重点科室医院感染监控,减少输液并合理使用抗菌药物。

A cross-sectional research analysis of the prevalence of infection in a third-grade comprehensive hospital in 2017

Objective To provide evidence for prevention and control of nosocomial infection by acquiring the current situation of nosocomial infection,and to evaluate the risk factors in the top 3 departments of nosocomial infection.Methods The technological method of combining the aid of the hospital monitoring sensors with professional vertification was used to investigate all hospitalized patients in Ma''anshan People''s Hospital from 0:00 to 24:00 on November 15,7.Results A total of 1 152 cases of hospitalized patients should be investigated,1 152 cases were investigated,and the actual investigation rate was 100%.There were 17 cases of nosocomial infection,the prevalence rate being 1.48%;18 cases of nosocomial infection,the infection rate was 1.56%.The lower respiratory infection was the main site of nosocomial infection (8 cases,44.44%).11 strains of pathogens were isolated on the day of investigation.The top three were Klebsiella pneumoniae (3 strains,27.27%),Escherichia coli (2 strains,18.18%) and Candida albicans (2 strains,18.18%).The top 3 departments with nosocomial infection cases were Department of Cardiac Surgery (4 cases),Department of Surgery 3 (3 cases),Department of Urinary Surgery and Department of Intensive Care (both 2 cases).Among the total of 1152 cases,1 048 cases received transfusion (90.97%),and 306 cases took antibacterial drugs (26.56%).A total of 282 cases of therapeutic drugs were used,and 172 cases of drugs were sent for examination,the test rate of therapeutic drugs was up to 60.99%.Conclusions Since the use of on-line real-time monitoring software in the whole hospital in 2016,there has been no underreport of hospital infection,and the prevalence rate is controlled at a lower level.Therefore,monitoring should be strengthened to those key parts,key links,and key departments to reduce transfusion and use antibacterial drugs properly.