苏州地区近五年医院感染调查分析  

Analysis of Nosocomial Infection in Suzhou Area from 2004 to 2008

作　　者：秦爱兰[1] 熊桂珍[2] 刘月秀[1] 李新芳[1] 范斌[1] 邓长卿[1] 甘建和[1] 

机构地区：[1]苏州大学附属第一医院感染科,江苏苏州215006 [2]江西省宜春学院第二附属医院,江西宜春336000

出　　处：《公共卫生与临床医学》2010年第1期41-45,共5页Public health and dinical medicine

基　　金：苏州市社会发展基金课题（编号：SS0704）

摘　　要：目的探讨苏州地区医院感染流行状况及临床分离菌株的耐药特点，为预防与控制医院感染提供科学依据。方法采用回顾性调查方法，对苏州地区2004～2008年32所医院住院患者医院感染进行调查分析。结果苏州地区五年医院感染发生率为2．6％。医院感染发生率最高的科室为监护病房（16．1％），最常见的部位为下呼吸道（40．5％）。男性构成比高于女性（（57-4％vs42．6％），年龄大于60岁的患者医院感染构成比（45.3％）最高，5—14岁的患者医院感染构成比（2．9％）最低。医院感染最常见的危险因素为慢性基础疾病、恶性肿瘤、泌尿道插管与气管切开、插管及放化疗。医院感染病原菌中，革兰阴性菌感染率（46．2％）最高，真菌呈逐年上升趋势（29．9％）。医院感染病原菌耐药率均较高，产超广谱β-内酰胺酶的大肠埃希菌、肺炎克雷伯菌阳性率为22。8％、17．9％，MRSA、MRSE阳性率分别为44．4％与55．4％。结论医院感染形势严峻，需采取合理措施控制医院感染，降低细菌耐药率。Objective To investigate the prevalence of nosocomial infection in Suzhou area and to characterize the pathogens isolated from infected patients. Mehtods The data from hospitalized cases of 32 hospitals in Suzhou （from 2004 to 2008） were analysed by retrospective study. Results From 2004 to 2008, nosocomical infection occurred in 2.6% cases. The highest incidence of nosocomial infection occurred in intensive care unit （16.1%） and in the lower respiratory tract （40.5%）. Male patients were likely to suffer from nosocomial infection than female patients （57.4% vs 42.6%）. Patients older than 60 years old were highly susceptible to nosocomial infection （45.3%） whereas patients from 5 years old to14 years old were the most resistant to nosocomial infection （2.9%）. Chronic diseases, cancer, urinary tract intubation, tracheostomy, radiotherapy and chemotherapy were identified as risk factors associated with nosocomial infection with the occurrence of 17.0%,15.3%,10.7%,7.7%,7.5% respectively. In all isolates from nosocomial infections, the gram-negative bacteria infection ranked as the first （46.2%） and followed by fungi infection （29.9%）, gram-positive bacteria （21.7%）. Drug resistance of bacterium from nosocomicl infecion is highly prevalent. The overall resistance continueously increase over time. The extended-spectrum β-lactamase were produced in 22.8% Escherichia coloi and 17.9% Klebsiella pneumoniae respectively. The methicillin-resistant Staphylococcus aureus （MRSA） occurred in 44.4% cases and Staphylococcus epidermidis （MRSE） in 55.4%. Conclusions The nosocomical infecion frequently occurred in Suzhou area with a severe drug-resistant profile. It is urgent to control nosocomical infection and reduce the occurrence of bacterial drug resistance by reasonable approaches.

关 键 词：医院感染 调查分析 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]