大型医院肝胆外科医院感染现况描述  

Current status of prevalence of nosocomial infections in hepatobiliary surgery department of a large-scale hospital

作　　者：王莎莎[1] 杜明梅[2] 杨洁[2] 索继江[2] 邢玉斌[2] 贾宁[2] 高岩[2] 任世旺[2] 刘伯伟[2] 谢丽君[2] 李璐[2] 刘运喜[2] 

机构地区：[1]潍坊医学院公共卫生与管理学院,山东潍坊261053 [2]解放军总医院感染管理与疾病控制科,北京100853

出　　处：《中华医院感染学杂志》2016年第18期4182-4184,4212,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金项目(30872155);国家科技重大专项"艾滋病和病毒性肝炎等重大传染病防治"子课题(2013ZX10004 805-003;2013ZX10004 217-002;2009ZX10004-204);全军医学科技"十二五"科研项目(重大专项AWS11L009;保健专项11BJZ01);部队卫生和疾病预防控制应用性研究课题(13BJYZ31)

摘　　要：目的利用医院感染实时监控系统(RT-NNIS)分析医院肝胆外科医院感染情况,明确重点感染部位、主要病原菌及相关危险因素,为临床预防控制医院感染提供依据。方法收集2012年1月1日-2015年12月31日肝胆外科16 820例患者资料,对其感染率、感染部位及致病菌应用构成比进行统计描述,利用单因素分析研究医院感染的相关因素。结果观察期间,肝胆外科5个病区总住院患者为16 820例,其中感染819例,总感染率为4.87%,感染部位前3位依次为手术部位感染、菌血症、下呼吸道感染,主要致病菌前3位依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌;单因素分析结果显示,男性、年龄≥65,手术、入住ICU、使用抗菌药物及使用中心静脉插管、尿管、呼吸机是肝胆外科发生医院感染的危险因素(P<0.05)。结论肝胆外科医院感染发病率较高,菌种和感染部位较为集中,临床工作中应对重点感染部位和重点菌种高度重视。OBJECTIVE To analyze the prevalence of nosocomial infections in department of hepatobiliary surgery by using real-time national nosocomial infection surveillance（RT-NNIS）system and define the key infection sites,major species of pathogens,and related risk factors so as to provide guidance for clinical prevention and control of the nosocomial infections.METHODS The data were collected from 16 820 patients who were treated in the department of hepatobiliary surgery from Jan 1,2012 to Dec 31,2015,then the statistical description was performed for the infection rates,infection sites,and constituent ratios of pathogens,and the univariate chi-square analysis was carried out for the related factors.RESULTS Of totally 16820 patients who were hospitalized in 5wards of the department of hepatobiliary surgery,819 had infections,with the total infection rate 4.87%.The top 3infection sites were in turn as follows：the surgical sites,bacteremia,lower respiratory tract.The top 3species of pathogens were in turn as follows：the Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli.The result of the univariate analysis showed that the risk factors for the nosocomial infections in the department of hepatobiliary surgery included the male,no less than 65 years of age,surgery,ICU stay,and use of antibiotics as well as use of central venous catheter,urinary catheter,and ventilator（P〈0.05）.CONCLUSIONThe incidence of nosocomial infections remains high in the department of hepatobiliary surgery;the species of pathogens and infection sties are relatively concentrated.It is necessary for the hospital to attach great importance to the key infection sites and the major species of pathogens.

关 键 词：肝胆外科 医院感染 病原菌 

分 类 号：R181.32[医药卫生—流行病学]