河北省253所医院住院患者医院感染与社区感染现患率比较  

Prevalence rates of healthcare-associated infection and communityassociated infection in hospitalized patients in 253 hospitals of Hebei Province

作　　者：刘晓[1] 王彤[1] 蒋怡芳[1] 邢亚威[1] 刘志广[1] 王媛[1] 杨兴肖[1] 孔洁羽 LIU Xiao;WANG Tong;JIANG Yi-fang;XING Ya-wei;LIU Zhi-guang;WANG Yuan;YANG Xing-xiao;KONG Jie-yu(Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China)

机构地区：[1]河北医科大学第四医院,河北石家庄050011

出　　处：《中国感染控制杂志》2017年第12期1126-1129,1136,共5页Chinese Journal of Infection Control

基　　金：河北省卫生厅青年科技课题(20150316)

摘　　要：目的了解河北省医院住院患者医院感染与社区感染现状。方法选取2015年8月17—28日期间的某一日为调查日,统一制定调查表,调查河北省二级及以上综合医院住院患者医院感染与社区感染的现患情况,并对感染病原菌进行分析比较。结果共调查253所医院,调查65 065例患者,医院感染现患率为2.89%,社区感染现患率为16.84%。医院感染部位居前3位的依次为呼吸道(61.32%)、泌尿道(12.49%)与手术部位(9.83%),社区感染部位居前3位的依次为呼吸道(56.70%)、泌尿道(10.89%)与胃肠道(8.35%)。医院感染与社区感染感染部位分布差异有统计学意义(P<0.01)。医院感染与社区感染前5位病原菌种类相同,排列顺序不同,医院感染病原菌以铜绿假单胞菌为主,占22.69%,社区感染病原菌以大肠埃希菌为主,占23.79%,医院感染与社区感染检出病原菌分布差异有统计学意义(P<0.01)。医院感染与社区感染在呼吸道、胃肠道、泌尿道、腹腔内组织感染中病原菌种类差异均有统计学意义(均P<0.05)。产超广谱β-内酰胺酶/耐碳青霉烯类肺炎克雷伯菌、耐甲氧西林金黄色葡萄球菌医院感染与社区感染菌株的检出率比较,差异均有统计学意义(均P<0.001)。结论医院感染与社区感染在感染发病率、感染部位分布、病原菌构成及多重耐药菌检出等方面均有差异,应在加强医院感染监控的同时,关注社区感染病原体的耐药性监测,为临床合理用药提供科学依据。ObjectiveTo investigate prevalence of healthcare associated infection(HAI)and community associated infection(CAI)in hospitalized patients in Hebei Province.MethodsA certain day from August17to August28,2015was selected as the survey day,unified questionnaires were formulated,the prevalence of HAI and CAI in hospitalized patients in secondary and above comprehensive hospitals in Hebei Province was surveyed,pathogens causing infection were analyzed and compared.ResultsA total of65065patients in253hospitals were surveyed,prevalence rates of HAI and CAI were2.89%and16.84%respectively.The top three sites of HAI were respiratory tract(61.32%),urinary tract(12.49%),and surgical site(9.83%),the top three sites of CAI were respiratory tract(56.70%),urinary tract(10.89%),and gastrointestinal tract(8.35%).Distribution of sites of HAI and CAI was significantly different(P<0.01).The top5pathogens were of the same species,but ranked differently,the main bacteria causing HAI was Pseudomonas aeruginosa(22.69%),CAI was Escherichia coli(23.79%).There was significant difference in the distribution of pathogens between HAI and CAI(P<0.01).There were significant differences in pathogenic species causing respiratory tract,gastrointestinal tract,urinary tract,and intra abdominal infection(all P<0.05).Isolation rates of extended spectrumβlactamase producing/carbapenem resistant Klebsiella pneumoniae,methicillin resistant Staphylococcus aureus between HAI and CAI were all significantly different(all P<0.001).ConclusionIncidence of infection,infection sites,as well as constituent of pathogens and multidrug resistant organisms between HAI and CAI are varied,besides monitoring on HAI,monitoring on drug resistance of pathogens causing CAI should be paid attention,so as to provide scientific basis for rational antimicrobial use in clinical practice.

关 键 词：现患率 医院感染 社区感染 调查 

分 类 号：R181.32[医药卫生—流行病学]