医院感染现患率调查分析与防控

目的通过实施现患率调查，了解医院感染基本情况，为改进医院感染预防与控制措施提供科学依据，有效控制、减少医院感染发生率。方法首先做好调查前规划，确定调查时间，对调查人员统一培训。采用床旁与病历调查相结合的横断面调查方法，对2011年10月19日的住院患者进行医院感染现患率调查，填写统一医院感染现患率调查表，对调查日处于医院感染状态的病例进行统计分析与反馈。结果此次调查的住院患者共863例，实查率100％，发生医院感染32例，34例次，医院感染率为3．71％，列次率为3．94％。医院感染高发科室主要为ICU30．00％、骨伤科8．82％、感染化疗科7．78％。医院感染部位主要为下呼吸道感染（13例，38．20％）、上呼吸道感染（8例，23．50％）、泌尿系感染（5例，14．70％）、II类切口（3例，8．80％）、伤口（2例，5．90％）。抗菌药物使用466例，使用率54．00％，治疗性用药微生物送检率为24．03％。外科抗菌药物使用率49．80％，内科抗菌药物使用率为59．52％，外科以预防性用药为主占47．13％，内科以治疗性用药为主占83．33％。结论通过现患率的调查，真正了解医院感染发生情况，加强高危重点科室、重点部位的感染监测，规范操作行为、抗菌药物的正确使用，是控制医院感染、提高医疗质量最有效的方法。

Investigation and preventive control on prevalence rate of nosocomial infection

Objective To understand the base situation of nosocomial infection （NI） by investigation to provide the scientific basis for preventing and controlling NI and reducing NI rates. Methods We should make sure the investigation time and provide training for investigators, The cross section investigation method was used, combined with bedside exam and medical record investigation, investigating the prevalence rates of inpatient on the date of October 19, 2011, filling in the unified hospital infection prevalence table and carrying on the statistical analysis and the feedback on the investigative date to be at the NI condition. Results All 863 cases were involved during the surveillance, of which 32 patients acquired. The prevalence rate was 3.71% and the prevalence rate of case-times was 3.94%. The several highest infection rates were ICU （30.00%）, department of Orthopaedics and Tranmatology （8.82%） and infectious diseases （7.78%）. The main infected sites were lower respiratory tract （38.20%）, upper respiratory tract （23.5%）, urinary tract （14.70%） II incision（8.80%） and wound （ 5,90% ） . 466 cases were using antibiotics and the utilization ratio was 54.00%, remedial microorganism＇ s examing rate was 24.14%. The usage rate of antibiotics in surgery was 49.80% and the usage rate of antibiotics in medical department was 59.52%. Conclusion The current situation of NI can be better known after investigating. The most effective way to control NI and improve the medical quality was strengthening and monitoring hospital infection in high risk departments and sites, managing the medical personnel＇ s behavior and regulating the proper use of antibacterial drugs.