1990～2002年神经外科医院感染监测情况分析

目的　调查某院神经外科住院患者医院感染发生情况 ,以便采取有效预防控制措施。方法　采用回顾性与前瞻性监测对比分析 1990～ 2 0 0 2年该科住院患者的医院感染情况。结果　 1990～ 1991年 (回顾性监测 )的医院感染率为 13.31% ,1992～ 2 0 0 2年 (前瞻性监测 )为 5 .6 9% ,两者差异有显著性 (χ2 =73.73,P <0 .0 0 5 )。感染部位以下呼吸道感染率最高 ,为 5 5 .10 % ;医院感染病原菌中革兰阴性 (G-)菌占 4 7.87% ,革兰阳性 (G+ )菌占39.81% ,真菌占 12 .32 %。各疾病以高血压性脑出血患者感染率最高 ,为 13.6 7%。结论　有效预防控制神经外科医院感染率 ,宜采取前瞻性监测方法 ,有针对性地重点监测 ;应尽量减少各种侵入性操作 ,加强基础护理和专科护理 ;提高送检率 ,以明确病原学诊断 ,指导合理用药。

Analysis of nosocomial infection in patients in neurosurgical department from 1990 to 2002

Objective To investigate nosocomial infection (NI) in patients in neurosurgical department and take effective prevention measures. Methods NI in patients in neurosurgical department from 1990 to 2002 was analysed retrospectively and prospectively. Results NI rate was 13.31% from 1990 to 1991 by retrospective monitor; NI rate was 5.69% from 1992 to 2002 by prospective monitor, there was significant difference between retrospective and prospective monitor. Lower respiratory tract infection was the most common infection, which was 55.10%. Among pathogens causing NI, gram-negative bacteria, gram-positive bacteria and fungi accounted for 47.87%, 39.81% and 12.32% respectively. NI rate was the highest in patients with hypertention associated with intrcranial hemorrhage, which was 13.67%. Conclusion Prospective monitor should be adopted to prevent NI rate in patients in neurosurgical department; various invasive procedures should be reduced; basic and special nursing should be strengthened; pathogenic detection should be stressed to guide the rational use of antimicrobial agents.