2015年河北省253所医院内外科感染现患率的对比分析  

Point prevalence of infection between departments of internal medicine and surgery in 253 hospitals of Hebei province

作　　者：刘晓[1] 王彤[2] 蒋怡芳[3] 邢亚威[1] 刘志广[1] 王媛[1] 杨兴肖[1] 孔洁羽 

机构地区：[1]河北医科大学第四医院感染管理科,河北石家庄050011 [2]河北医科大学第四医院胸外科,河北石家庄050011 [3]河北医科大学第四医院呼吸内科,河北石家庄050011

出　　处：《现代预防医学》2017年第7期1327-1331,共5页Modern Preventive Medicine

基　　金：河北省卫生厅青年科技课题;项目编号:20150316

摘　　要：目的调查内、外科医院与社区感染的现患情况。方法采用横断面调查方法,调查2015年河北省253所医院内、外科医院与社区感染现患率、病原菌检出以及抗菌药物使用情况。结果共调查65 065例患者,内外科医院感染现患率分别为2.7%与3.2%,社区感染现患率分别为21.3%与10.5%,差异有统计学意义(P<0.001)。感染部位中前3位,外科医院感染为下呼吸道、手术部位与泌尿道,社区感染为皮肤软组织、腹腔内组织与泌尿道;内科均为下呼吸道、上呼吸道与泌尿道。医院感染中,内科产超广谱β-内酰胺酶/耐碳青霉烯肺炎克雷伯菌与耐甲氧西林金黄色葡萄球菌检出率分别为44.6%与20.5%,外科分别为22.7%与42.2%,差异均有统计学意义(P<0.05);社区感染中,内科各多重耐药菌检出率均显著高于外科(P<0.05)。内外科抗菌药物使用率分别为24.4%与44.6%,内科93.0%为治疗用药,外科53.6%为预防用药,差异有统计学意义(P<0.05)。结论内外科医院与社区感染在感染部位、多重耐药菌检出、抗菌药物使用等方面均有差异,应加强感染的监控和病原菌送检。Objective To investigate point prevalence of healthcare - associated infection （HAI） and community - associated infection （CAI） in departments of internal medicine and surgery of Hebei province. Methods A cross - sectional survey was conducted to investigate daily HAl and CAI rate, specimen detection and antimicrobial usage in 253 hospitals participated in the survey in 2015. Results A total of 65065 patients were investigated. There was significant difference between departments of internal medicine and surgery in both HAI （2.7% vs. 3.2% ,P 〈0. 001 ） and CAI （21.3% vs. 10.5% ,P 〈0. 001 ）. The top 3 infection sites of both HAI and CAI were lower respiratory tract, upper respiratory tract and urinary tract in internal medicine, and the top 3 infection sites of HAI in surgery were lower respiratory tract, surgical sites and urinary tract, which of CAI were skin and soft tissues,intra - abdominal carvity and urinary tract. Both the detected rate of ESBLs （ ＋ ） /CR - KP and MRSA were statistically significant （ P 〈 0.05 ）. The detected rate of main muhidrug - resistant Organisms （MDROs） of internal medicine was significantly higher than that of surgery （ P 〈 0.05 ） in CAI. Antimicrobial usage rate was 24.4% of internal medicine and 44.6% of surgery, respectively. The therapeutic usage rate of internal medicine was 93.0% ,while preventive usage rate of surgery was 53.6%, and the differences were statistically significant （ P 〈 0.05 ）. Conclusion There are differences between internal medicine and surgery among infection sites, common MDROs strains and antimicrobial use, etc. W.e should strengthen hospital infection monitoring and control, and improve the bacterial detection rate.

关 键 词：现患率 医院感染 社区感染 病原菌 抗菌药物 

分 类 号：R181.23[医药卫生—流行病学]