不同级别医疗机构医院感染横断面研究  

A cross-sectional study on nosocomial infections among medical institutions at different levels

作　　者：谭军 周爱军[2] 翁晓芳[2] 袁艳玲[2] 刘程琳 王剑云 TAN Jun1,2, ZHOU Aijun2, WENG Xiaofang2, YUAN Yanling2, LIU Chenglin1,2, WANG Jianyun1,2(1. School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, ]iangxi 330006, P. R. China; 2. Hospital Infection Control Department, Baoshan Branch of Shanghai First People＇s Hospital, Shanghai 200940, P. R. Chin)

机构地区：[1]南昌大学江西医学院公共卫生学院,南昌330006 [2]上海市第一人民医院宝山分院医院感染管理科,上海200940

出　　处：《华西医学》2018年第3期279-283,共5页West China Medical Journal

基　　金：上海市宝山区科学技术委员会课题(17-E-7)

摘　　要：目的比较不同级别医院的医院感染流行现状。方法采用横断面调查方法,于2014年11月12日、2015年12月9日、2016年11月30日00:01—24:00期间上海市宝山区20所医疗机构所有住院患者进行床旁调查和病史查阅相结合的方法,收集不同级别医院医院感染现患率、感染分布以及抗菌药物使用情况。结果 2014年—2016年每年调查1次,共调查住院患者18 762例,医院感染现患率分别为一级医院5.36%、二级医院2.37%、三级医院1.68%(χ2=88.497,P<0.05);医院感染部位构成比中,一、二级医院前3位均为下呼吸道、泌尿道、上呼吸道,三级医院为其他部位、下呼吸道、上呼吸道;一、二、三级医院抗菌药物使用率分别为5.88%、31.64%、42.11%(χ2=928.148,P<0.05),标本送检率分别为9.82%、48.89%、82.39%(χ2=601.347,P<0.05);病原体报告分别为一级医院4例,二级医院94例,三级医院96例;不同医院级别、性别、年龄、科室的住院患者医院感染现患率不同(P<0.05)。结论一级医院需加强标本送检,三级医院需严格限制抗菌药物使用,且应进一步细化医院感染防控工作。Objective To compare the epidemic status of nosocomial infections （NIs） among medical institutions at different levels. Methods The cross-sectional surveys on prevalence rates of NIs, distribution of NIs, and antimicrobial use were conducted through combination of bedside investigation and medical record reviewing among all in-patients of 20 medical institutions in Baoshan District, Shanghai from 00：01 to 24：00 on November 12th 2014, December 9th 2015, and November 30th 2016, respectively. Results A total of 18 762 patients were investigated, the prevalence rate of NIs in the first, second, and third class hospitals were 5.36%, 2.37%, 1.68%, respectively （χ^2=88.497, P〈0.05）. The main NIs sites were lower respiratory tract, urinary tract, and upper respiratory tract in the first and second grade hospitals; while were other unclassified sites, respiratory tract, and upper respiratory tract in the third grade hospitals. The utilization rates for antimicrobial in the first, second, and third grade hospitals were 5.88%, 31.64%, and 42.11%, respectively （χ^2=928.148, P〈0.05）; submission rates for specimen were 9.82%, 48.89%, and 82.39%, respectively （χ^2=601.347, P〈0.05）. Four cases of pathogen were reported in the first grade hospitals, 94 in the second grade hospitals, and 96 in the third grade hospitals. The in-patients in different hospitals with different genders, ages, and departments had a statistical difference in prevalence rate of NIs （P〈0.05） . Conclusion The first grade hospitals need to enhance the etiological examination; the third grade hospitals should severely restrict the antimicrobial utilization, and refine the prevention and control work for NIs.

关 键 词：医院感染 横断面研究 对比分析 

分 类 号：R197.323[医药卫生—卫生事业管理]