2016—2020年武汉市医院感染横断面调查结果趋势研究

目的 了解武汉市医疗机构医院感染和社区感染现状，分析医院感染的流行趋势与管理重点。方法 采用病历调查和床旁调查相结合的方法，按照全国医院感染监控管理培训基地制定的全国医院感染横断面调查表进行调查，分析2016、2018、2020年的调查数据。结果 2016、2018、2020年武汉市医院感染现患率分别为2.66%、2.21%、1.85%,社区感染现患率分别为17.81%、17.82%、16.29%,均呈下降趋势(均P<0.05)。医院感染现患率较高的科室为综合重症监护病房(ICU)、血液病科(组)、神经外科、胸外科、儿科新生儿组；社区感染现患率较高的科室为儿科非新生组、呼吸科(组)、感染病科(组)、综合ICU、儿科新生儿组。医院感染、社区感染感染部位均以下呼吸道为主，其中2016、2018、2020年术后下呼吸道医院感染构成比分别为12.85%、18.39%、22.09%。2016、2018、2020年手术部位医院感染现患率分别为0.99%、0.82%、0.69%。医院感染、社区感染病原体均以革兰阴性菌为主。结论 2016、2018、2020年武汉市医疗机构医院感染管理取得了较好...

Trend of cross-sectional survey results of healthcare-associated infection in Wuhan City from 2016 to 2020

Objective To understand the current situation of healthcare-associated infection (HAI) and community-associated infection (CAI) in medical institutions in Wuhan City, and analyze the epidemic trend and key management of HAI. Methods The combination of medical record and bedside survey was adopted to conduct a survey according to the table of cross-sectional survey formulated by National HAI Monitoring and Management Training Base. Survey data from 2016, 2018, and 2020 were analyzed. Results HAI prevalence rates in Wuhan City in 2016, 2018, and 2020 were 2.66%, 2.21%, and 1.85%, respectively. CAI prevalence rates were 17.81%, 17.82%, and 16.29%, respectively. Both showed decreasing trends (both P < 0.05). Departments with high pre-valence rates of HAI were the intensive care unit (ICU), departments (groups) of hematology, neurosurgery, thoracic surgery, and pediatric neonatal. Departments with high prevalence rates of CAI were the departments (groups) of pediatric non-neonatal, respiratory diseases, infectious diseases, general ICU, and pediatric neonatal. The main infection sites of HAI and CAI were lower respiratory tract. The proportions of postoperative HAI at lower respiratory tract in 2016, 2018, and 2020 were 12.85%, 18.39%, and 22.09%, respectively. HAI rates at surgical site in 2016, 2018, and 2020 were 0.99%, 0.82%, and 0.69%, respectively. HAI and CAI were mainly caused by Gram-negative bacteria. Conclusion The management of HAI in medical institutions in Wuhan City in 2016, 2018, and 2020 have made achievements. However, infection control in general ICU and of HAI at lower respiratory tract still need to be strengthened and improved.