某三甲医院医院感染现患率与抗菌药物应用横断面调查  

Cross sectional investigation on prevalence rate of nosocomial infections and antibiotics usage in first-class hospital at Grade 3

作　　者：薛菊兰[1] 万正东[2] 王向荣 高祖梅[1] 樊宏英[1] 胡晓原[4] 

机构地区：[1]长江大学附属第一医院感染管理办公室,湖北荆州434000 [2]长江大学临床医学院外科系,湖北荆州434023 [3]湖北省中医药大学护理学院,湖北武汉430065 [4]中南大学湘雅医学院医学系,湖南长沙410013

出　　处：《中华医院感染学杂志》2016年第3期557-560,共4页Chinese Journal of Nosocomiology

基　　金：湖北省教学科学"十二五"规划基金资助项目(2012B083)

摘　　要：目的动态评估医院感染管理成效,了解三甲医院医院感染的高危科室、高危人群、感染高危因素以及抗感染药物应用现状,为制定和落实目标监测方案和持续质量改进方案提供依据。方法于2014年10月16日0∶00-24∶00采用横断面调查方式对某三甲医院住院患者医院感染现患率和抗菌药物使用进行调查和记录,采用SPSS19.0统计软件对各科医院感染现患率、感染部位分布、病原菌检出分布、抗菌药物的使用与病原学送检等进行描述和分析。结果实际调查住院患者2 203例,发生医院感染68例、71例次,医院感染现患率3.09%、例次感染率3.22%;不同标本中检出的病原菌均以革兰阴性菌为主,均>60.00%,呼吸道感染病原菌主要为肺炎克雷伯菌、副流感嗜血菌,尿道和腹腔感染病原菌主要为大肠埃希菌;抗菌药物使用率为40.04%,以治疗性和一联用药为主,分别占61.90%和73.58%,感染病原菌标本送检率为32.20%。结论病原学标本送检和围手术期预防性抗菌药使用为医院感染管理的薄弱环节,均应纳入医院目标监测范围开展实时监控和采取前瞻性干预措施,以保障患者安全和遏制多药耐药菌产生。OBJECTIVE To assess the effectiveness of nosocomial infection management dynamically,and to understand the high-risk departments,population and factors in nosocomial infections and status of antibiotics usage,so as to provide the evidence for developing next stage target monitoring schema and continuous quality improvement program.METHODS Nosocomial infection prevalence rate and antibiotics usage were investigated and recorded in a First-class Hospital at Grade 3through cross-sectional survey from 0∶00to 24∶00on October 16,2014.SPSS19.0was adopted to statistically analyze the prevalence rate,infection sites distribution,pathogen distribution,use of antibiotics and etiology inspections.RESULTS Totally 2203 cases of inpatients were surveyed actually,in which inpatients with nosocomial infection was 68,and cases of infection were 71.The prevalence rate of nosocomial infection in the hospital was 3.09%,and the case prevalence rate was 3.22%.Gram-negative bacteria were all dominated in pathogens detected in different samples,accounting for more than 60%.The main pathogens causing respiratory tract infections were Klebsiella pneumoniae,Haemophilus parainfluenzae,while pathogens causing urethra and abdominal cavity infection were mainly Escherichia coli;usage rate of antibiotics was 40.04%,mainly for the treatment and one drug therapy,accounting for 61.90% and 73.28% respectively.The specimen submission rate for pathogen detection was 32.20%.CONCLUSIONSpecimen submissions for pathogen detection and prophylactic antibiotics use in perioperative period are weak links of nosocomial infection management,so all of above should be incorporated into the target monitoring in hospital to carry out the real-time monitoring and to take prospective intervention measures to ensure the safety of patients,and suppress emergence of multiple drugresistant strains.

关 键 词：医院感染 现患率 抗菌药物 调查分析 

分 类 号：R181.32[医药卫生—流行病学]