住院患者医院感染现患率调查分析  

Investigation and analysis of prevalence rate of nosocomial infections in hospitalized patients

作　　者：刘桂玲[1] 丁虹伶[1] 徐云钦[1] 鲁俊晶[1] 李强[1] 

机构地区：[1]解放军第98医院院感科,浙江湖州313000

出　　处：《中华医院感染学杂志》2015年第1期108-110,共3页Chinese Journal of Nosocomiology

基　　金：南京军区医学科技创新基金项目(11MA009)

摘　　要：目的调查医院感染发生情况和趋势,了解临床抗菌药使用状况,为规范抗菌药的使用提供依据。方法采取床旁调查和查阅住院病历相结合的方法,对调查当日所有住院患者进行医院感染现患率和抗菌药使用情况调查。结果 2013年5月16日住院患者753例,实查住院患者752例,实查率为99.87%;发生医院感染34例、36例次,感染现患率4.52%,例次感染率4.65%;呼吸道、手术切口、泌尿道是医院感染高发部位,医院感染部位构成:呼吸道感染16例次,感染率38.9%,手术切口感染6例次,感染率16.67%,泌尿道感染6例次,感染率16.7%;女性、年龄<2岁或>60岁、泌尿道插管、动静脉插管、使用呼吸机与发生医院感染有相关性;抗菌药物使用率为32.01%,治疗性使用抗菌药物病原学送检率为20.33%;共分离出病原菌34株,其中革兰阴性菌21株,革兰阳性菌13株,未检测到真菌。结论现患率调查应加强重点部门人群、重点部位的目标监测与管理;加强抗菌药物的监控与管理,降低预防为目的的抗菌药物使用,提高病原学送检率,正确、合理使用抗菌药物。OBJECTIVE To investigate the prevalence of nosocomial infections and understand the status of clinical use of antibiotics so as to provide guidance for reasonable clinical use of antibiotics.METHODS By means of bedside survey combined with review of medical records,the prevalence rate of nosocomial infections and the use of antibi-otics of all the hospitalized patients were surveyed on the survey day.RESULTS On May 16,2013,a total of 753 hospitalized patients were expected to investigate,and 752 cases were actually investigated with the actual investi-gation rate of 99.87%.The nosocomial infections occurred in 34 （36 case-times ）with the prevalence rate of 4. 52% and the case-time infection rate of 4.65%.The respiratory tract,surgical incision,and urinary tract were the high risk infection sites;there were 16 （38.9%）case-times of respiratory tract infections,6 （16.67%）case-times of surgical incision infections,and 6 （16.7%）case-times of urinary tract infections.The incidence of nosocomial infections was associated with the female,less than 2 years of age or more than 60 years of age,urinary tract intu-bation,arteriovenous intubation,and use of ventilator.The utilization rate of antibiotics was 32.01%,and the etiological submission rate for the therapeutic use of antibiotics was 20.33%.Totally 34 strains of pathogens have been isolated,including 2 1 strains of gram-negative bacteria and 1 3 strains of gram-positive bacteria,and the fungi were not found.CONCLUSION For the survey of prevalence rate,it is necessary to strengthen the targeted monito-ring and management of populations in the key departments as well as the key sites,enhance the surveillance and management of antibiotics,reduce the utilization of prophylactic antibiotics,raise the etiological submission rate, and reasonably use antibiotics.

关 键 词：医院感染 现患率 危险因素 抗菌药物 合理用药 

分 类 号：R181.32[医药卫生—流行病学]