某三级医院医院感染风险评估  

Assessment of risk of nosocomial infections in a three A hospital

作　　者：周春莲[1] 陈惠清[1] 王世英[1] 周翠云[1] 邓明卓[1] 郭青青[1] 

机构地区：[1]首都医科大学附属北京友谊医院感染管理科,北京100050

出　　处：《中华医院感染学杂志》2015年第2期360-362,共3页Chinese Journal of Nosocomiology

基　　金：中华医院感染控制研究基金资助项目(ZHYY12-011)

摘　　要：目的对某三级医院医院感染风险进行评估,寻找高风险科室,为制定医院感染控制策略提供依据。方法回顾性分析某院2010-2012年上报的1 474例医院感染及1 580例多药耐药菌感染患者临床资料。结果 2010-2012年共监测出院患者119 598例,上报医院感染1 474例,医院感染率为1.23%;各年度间医院感染率差异有统计学意义(χ2=50.0234,P<0.01),呈逐年下降趋势;医院感染率居前5位的科室依次为ICU、急诊科、神经外科、肾内科、医保中心,2012年感染率分别为19.59%、8.45%、4.75%、3.28%、2.95%;与2011年相比,2012年ICU、神经外科医院感染率下降明显,分别下降了8.64%、3.80%,急诊科医院感染率呈逐年上升趋势(Z=-4.4646,P<0.01);多药耐药菌检出率居前3位的科室为ICU、急诊科、神经外科,其中ICU检出率呈逐年下降趋势(χ2=8.7845,P=0.012),急诊科检出率呈逐年上升趋势(χ2=10.3719,P=0.006)。结论 ICU医院感染率虽然有所下降,但仍是感染率最高的科室,需继续加强控制;神经外科医院感染控制效果明显;应重点控制急诊科医院感染和多药耐药菌传播。OBJECTIVE To assess the risk of nosocomial infections in a three A hospital and find out the high-risk departments so as to put forward strategies for control of nosocomial infections.METHODS The clinical data of1 474 cases of nosocomial infections and 1 580 cases of multidrug-resistant bacteria infections who were reported from 2010 to 2012were retrospectively analyzed.RESULTS From 2010 to 2012,totally 119 598 discharged patients were monitored,and 1 474 cases of nosocomial infections were reported,with the incidence rate of nosocomial infections of 1.23%;there was significant difference in the incidence of nosocomial infections between 2010,2011,and 2012（χ^2=50.0234,P〈0.01）,and it showed a downward trend.The ICU,emergency department,neurosurgery department,nephrology department,and health care center ranked the top five incidence of nosocomial infections,the infection rates were respectively 19.59%,8.45%,4.75%,3.28%,and 2.95%in 2012;as compared with the incidence of nosocomial infections in 2011,the incidence of nosocomial infections in the ICU and neurosurgery department were significantly decreased in 2012,with the decreased of 8.64% and 3.80%,respectively;the incidence of nosocomial infections in the emergency department showed an upward trend（Z=-4.4646,P〈0.01）.The isolation rates of multidrug-resistant bacteria in the ICU,emergency department,and neurosurgery department ranked the top three places,and the isolation rate was decreased year by year in the ICU（χ^2=8.7845,P=0.012）,while the isolation rate was increased year by year in the emergency department（χ^2=10.3719,P=0.006）.CONCLUSION Although the incidence of nosocomial infections is decreased in the ICU,it remains the highest,and the control of infections should be further strengthened;the effect on control of nosocomial infections is remarkable in the neurosurgery department;it is necessary to focus on the control of nosocomial infections in the emergency department and the spread of multidrug-resistant bacteria.

关 键 词：医院感染 风险评估 多药耐药菌 

分 类 号：R181.32[医药卫生—流行病学]