医院感染现状与抗菌药物合理应用分析  

Current status of nosocomial infections and reasonable use of antibiotics

作　　者：江明君[1] 罗建平[2] 

机构地区：[1]宁波大学医学院附属鄞州医院胸外科,浙江宁波315040 [2]宁波大学医学院附属鄞州医院检验科,浙江宁波315040

出　　处：《中华医院感染学杂志》2013年第23期5792-5794,共3页Chinese Journal of Nosocomiology

基　　金：浙江省中医药重点基金项目(2011ZB135)

摘　　要：目的了解医院感染现状及抗菌药物应用,归纳总结1年医院用药规律及其发展趋势,为以后更深入和系统的流行病学调查研究提供参考依据。方法采用床旁调查与查看病历相结合,对2011年1月1日-2011年12月31日医院感染患者情况与抗菌药物使用进行统计分析。结果调查住院患者43 783例,实查41 879例,实查率95.65%,发生医院感染887例、1002例次,感染率2.12%、例次感染率为2.39%;感染率最高的科室为ICU;感染部位以下呼吸道感染为首,占26.45%;医院感染病原菌前3位依次为铜绿假单胞菌占25.59%、大肠埃希菌占20.08%、肺炎克雷伯菌占16.14%;抗菌药物使用率为54.14%;临床经验初始治疗与药敏相符率为46.62%。结论强化医院感染控制,提高抗菌药物使用合理性,检验科室应与临床各科室进行良好协作,建立实时沟通机制,根据临床用药的发展逐步完善药敏检测项目,以更好的指导临床治疗,为医院感染预防控制及治疗提供依据。OBJECTIVE To investigate the current status of incidence of nosocomial infections and the use of antibiotics, summarize the law of medication in the past year and observe the development trend so as to conduct further and systematic epidemiological study. METHODS By means of bedside investigation combined with review of medical records, the incidence of nosocomial infections and the use of antibiotics from Jan 1, 2011 to Dec 31, 2012 were statistically analyzed. RESULTS Totally 43 783 recruited cases were expected to investigate, and 41 879 cases were actually investigated with the actual investigation rate of 95.65 %, among whom the nosocomial infections occurred in 887 cases （1002 case-times） with the infection rate of 2.12% and the case-time infection rate of 2.39%. The incidence of the nosocomial infections was the highest in the ICU; 26. 45% of the cases of infections had the respiratory tract infections. Of the pathogens isolated, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae ranked the top three species, accounting for 25. 59%, 20. 08%, and 16. 14%, respectively. The utilization rate of antibiotics was 54.14 %; the accordance rate between the clinical empirical initial treatment and the drug susceptibility was 46.62%. CONCLUSION It is an effective way to enhance the control of nosocomial infections, raise the rationality of use of antibiotics, strengthen the collaboration between the clinical laboratory department and other clinical departments, establish real-time communication system, and progressively perfect the drug susceptibility testing program in accordance with the trend of clinical medication so as to guide the clinical prevention and treatment of the nosocomial infections.

关 键 词：医院感染 抗菌药物 分析 

分 类 号：R978.1[医药卫生—药品]