西部地区某院2014年医院感染现患率调查分析  

The Prevalence Survey Analysis of Nosocomial Infection in A Western Region Hospital in 2014

作　　者：陆婷婷[1] 马春华[1] 李艳萍[1] 赵跃[1] 文佳[1] 张秀玲[1] 邹艳[1] 

机构地区：[1]绵阳市中心医院感染管理科,四川绵阳621000

出　　处：《华西医学》2015年第12期2266-2270,共5页West China Medical Journal

摘　　要：目的了解某院2014年医院感染现状,为医院感染的控制与管理提供科学依据。方法选择2014年8月14日00:00-24:00住院患者,采用床旁调查与病历调查相结合的方法对住院患者的感染情况进行横断面调查,填写调查表,对各科室患者的医院及社区感染相关数据进行统计分析。结果共监测1 908例患者,医院感染现患率为4.45%,社区感染患病率为29.09%。医院感染率最高的科室为综合重症监护病房(38.10%),外科系统排名前3位的科室为胸外科(18.67%)、普外科(16.67%)、神经外科(10.53%),内科系统排名前3位的科室为内分泌科(11.11%)、神经内科(6.67%)、感染科(5.88%)。社区感染率居于前3位的科室分别为儿科(非新生儿组)(95.37%)、烧伤外科(92.31%)、呼吸内科(86.46%)。医院感染和社区感染感染部位主要为下呼吸道(58.24%)。感染检出病原菌主要为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌,医院感染与社区感染的细菌谱一致,抗菌药物使用率40.82%;其中预防用药126例(6.60%),治疗用药599例(31.39%),治疗用药患者细菌培养送检率80.71%,送检阳性率43.78%。结论可进一步有针对性地制定监测方案,从而降低医院感染率。Objective To know the situation of nosocomial infection in 2014 in a western region hospital, in order to provide a scientii c basis for hospital infection control and management. Methods We selected the patients on August 14 th in 2014 during the time from 00：00 to 24：00 as our study subjects. Bedside investigation and medical records investigation were combined to study the cross-sectional survey of nosocomial infection. We completed the questionnaire, and used statistical methods to count related data about nosocomial infections and community-acquired infections. Results A total of 1 908 patients were investigated. h e nosocomial infection prevalence rate was 4.45%, and the communityacquired infection prevalence rate was 29.09%. The highest prevalence of nosocomial infection department was the Intensive Care Unit（38.10%）; the top three surgical systems were h oracic Surgery（18.67%）, General Surgery（16.67%）, and Neurosurgery（10.53%）, and the top three medical systems were Endocrinology（11.11%）, Neurology（6.67%）, and Infectious Diseases Department（5.88%）. h e top three community-acquired infections occurred in Pediatrics Department（non-neonatal group）（95.37%）, Burn surgery（92.31%）, and Respiratory Medicine（86.46%）. h e main infection site for both nosocomial and community-acquired infection was lower respiratory tract（58.24%）. Pathogens were mainly Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa. Hospital and community-acquired infection bacterial spectrum were consistent. And the rate of antibiotics use was 40.82%, in which 126 patients used for prevention（6.60%）, and 599 patients used for treatment（31.39%）. For patients using the drugs for treatment, bacterial culture submission rate was 80.71%, and the positive rate was 43.78%. Conclusion h e prevalence of nosocomial infection is reliable, which provides a data support for nosocomial infection prevention and control.

关 键 词：现患率 医院感染 病原菌 

分 类 号：R446.5[医药卫生—诊断学]