某市级医疗单位住院患者医院感染现患率调查分析及防控启示  

Investigation and Analysis of the Prevalence Rate of Inpatient Nosocomial Infections in A Municipal Medical Unit and Its Enlightenment on Prevention and Control

作　　者：夏娇[1,2] 郑晓红[1] 向丽佳[1] 杨勤勤[1] 张芝娇[1] 

机构地区：[1]成都市第二人民医院医院感染管理科,成都610027 [2]泸州医学院附属第一医院医院感染管理科

出　　处：《华西医学》2016年第1期67-71,共5页West China Medical Journal

摘　　要：目的了解市级医疗单位医院感染现况,为制定高危人群、高危环节的医院感染防控措施提供依据。方法按照2013年成都市医院感染质量控制中心对医院感染横断面调查的要求,对成都市第二人民医院2013年7月25日所有住院患者进行调查,并对结果进行统计学分析。结果应调查1 307例,实际调查1 301例,实查率99.54%,医院感染现患率为3.38%(44例)。感染率前5位科室分别为呼吸重症监护病房、中心重症监护病房、神经外科、胸外科和普外科。感染部位主要为呼吸道感染,占62.26%。单因素分析结果显示,年龄≥60岁、住院时间>2周、有侵入性操作、有糖尿病史、进行手术和放射/化学治疗、使用抗菌药物是医院感染的高危因素;多因素分析显示,住院时间(OR=3.115,P=0.001)、侵入性操作(OR=14.930,P<0.001)、糖尿病(OR=2.157,P=0.046)、放射/化学治疗(OR=7.497,P<0.001)是医院感染独立危险因素。所有住院患者中抗菌药物使用率为45.73%,其中一联用药占85.21%,治疗性用药占82.18%。结论了解医院感染的现况有助于市级医院掌握医院感染防控的重点和难点,制定针对高危人群、高危科室、高危环节的防控措施,并指导和督促临床科室落实,为进一步降低医院感染发生率指引方向。Objective To understand the current status of nosocomial infections in a municipal medical unit,to find problems in daily monitoring,and to provide the evidence for the prevention and control of nosocomial infection in high-risk groups and procedures.Methods According to the 2013 survey requirements made by the nosocomial infection control center of Chengdu,we made a cross-sectional survey about nosocomial infection among all the inpatients on July 25 th,2013 and statistically analyzed the results.Results Totally,1 301 cases were actually investigated within 1 307 inpatients of the time（the actual investigation rate was 99.54%）.The prevalence rate of nosocomial infection was 3.38%（44 cases）.The top five departments of infection rate were Respiratory Intensive Care Unit（RICU）,Center of Intensive Care Unit（CICU）,Department of Neurosurgery,Department of Thoracic Surgery and Department of General Surgery.The main site of infection was respiratory tract,which took possession of 62.25%.In univariate analyses,age 60,length of hospital stay 〉2 weeks,invasive operation,history of diabetes,operation,radiotherapy/chemotherapy,utilization of antibiotics were found to be risk factors for infections.Multivariate analysis showed that length of hospital stay（OR= 3.115,P= 0.001）,invasive operation（OR= 14.930,P〈0.001）,diabetes mellitus（OR= 2.157,P= 0.046）,radiotherapy/chemotherapy（OR= 7.497,P〈0.001） were independent risk factors for nosocomial infections.The utilization rate of antibiotics was 45.73%.Among them,there was 85.21%using single antibiotics,and 82.18%of them were used therapeutically.Conclusion Understanding the current status of nosocomial infection in municipal hospitals helps us grasp the key and difficulty of infection control,make out prevention-control measures for high-risk groups and high-risk departments,and guide and supervise its implementation in clinical departments,which points out the direction to further reduce the incidence of nosocomial infection.

关 键 词：医院感染 现患率 调查分析 防控启示 

分 类 号：R197.323[医药卫生—卫生事业管理]