综合医院精神科住院患者医院感染现状

目的了解综合医院精神科住院患者医院感染现状，对感染相关因素进行分析，以便针对性地采取预防措施，降低医院感染率。方法采取回顾性调查方法，对2009年1月1日-2011年12月31日在某院精神科住院的5 432例患者的病历资料进行统计分析。结果5 432例患者共发生医院感染438例、514例次，医院感染率和例次率分别为8.06%、9.46%；医院感染部位以上呼吸道（68.29%）为主，其次为下呼吸道（12.06%）和胃肠道（9.92%）等。不同原发疾病患者间医院感染率差异具有统计学意义（χ2=102.29，P＜0.001），其中以酒精性精神病患者医院感染率（23.40%）最高；季节分布，以冬季医院感染率和例次率最高，分别为11.82%（151例）、14.02%（179例次），冬季上呼吸道感染占上呼吸道感染总例数的40.74%（143/351）；不同管理方式病区的医院感染率差异具有统计学意义（χ2=59.58，P＜0.001），其中封闭式男病区感染率（12.83%）最高。结论综合医院精神科医院感染率较高，应根据季节变化、原发疾病易感性及不同的管理方式，采取针对性的感染控制措施，有效预防和控制医院感染的发生。

Healthcare associated infection in psychiatric inpatients in a general hospital

ObjectiveTo survey the current situation of healthcare associated infection （HAI）in psychiatric inpatients in a general hospital, analyze related factors for infection, and take preventive measures to reduce HAI rate.MethodsMedical records of 5 432 psychiatric patients in a hospital from January 1, 2009 to December 31, 2011 were analyzed retrospectively.ResultsOf 5 432 patients, 438 developed 514 times of HAI, HAI rate and case rate was 8.06% and 9.46% respectively; the major infection site was upper respiratory tract （68.29%）,followed by lower respiratory tract（12.06%） and gastrointestinal tract（9.92%）.The differences in HAI rates among patients with different primary diseases were statistically different（χ2=102.29，P＜0.001）, HAI rate was highest in alcoholic psychiatric patients（23.40%）;with regard to season, HAI rate and case rate was highest in winter season, which was 11.82%（151 cases） and 14.02%（179 times）respectively, upper respiratory tract infection in winter accounted for 40.74%（143/351） of total upper respiratory tract infection;the difference in HAI rate in patients receiving different management modes was statistically different （χ2=59.58，P＜0.001）,the highest infection rate was in the enclosed management male ward （12.83%）.ConclusionHAI rate in psychiatric patients in general hospital is high, in order to reduce the occurrence of HAI, proper measures should be taken according to the change in seasons, the susceptibility in primary diseases, and different management modes.