2012~2018年四川大学华西医院感染现患率的趋势分析  

Trend of prevalence rate of nosocomial infection in West China Hospital of Sichuan University from 2012 to 2018

作　　者：舒明蓉[1] 黄文治[1] SHU Mingrong;HUANG Wenzhi(Department of Infection Management,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院感染管理部,成都610041

出　　处：《中国循证医学杂志》2020年第7期759-763,共5页Chinese Journal of Evidence-based Medicine

摘　　要：目的调查四川大学华西医院医院感染现患率,分析医院感染控制措施执行效果,为感染控制提供依据。方法采取床旁调查和住院病历查询相结合的方式,对四川大学华西医院2012~2018年每年6月下旬某一天0~24时住院患者进行医院感染现患率调查,并由医院感染管理部专职人员进行数据核对、汇总和统计分析。结果 2012~2018年四川大学华西医院的感染现患率分别为5.19%、4.20%、3.94%、4.26%、4.29%、4.25%、2.97%,呈下降趋势(χ~2=32.826,P<0.001)。虽然内科总感染率各年度差异无统计学意义,但血液科的感染率呈下降趋势(χ~2=6.127,P<0.05);外科总感染率呈下降趋势(χ~2=18.721,P<0.001),其中胸外科的感染率呈下降趋势(χ~2=3.906,P<0.05);但重症医学科的感染率各年度差异无统计学意义。医院感染的重点部位构成比均以下呼吸道为主,各年度差异无统计学意义,其中术后肺炎从2014年开始呈上升趋势(χ~2=9.56,P=0.002)。历年构成比最高的医院感染病原体分别为:鲍曼不动杆菌(2012年、2013年、2014年、2017年、2018年)、肺炎克雷伯菌(2015年)、大肠埃希菌(2016年)。各年度抗菌药物使用率的差异无统计学意义(χ~2=3.75,P=0.053),而重症医学科的抗菌药物使用率呈下降趋势(χ~2=30.42,P=0.000)。结论四川大学华西医院医院感染现患率呈下降趋势,但下呼吸道的感染问题仍需保持足够重视,尤其对术后肺炎患者。Objective To investigate the prevalence rate of nosocomial infection in West China Hospital of Sichuan University and to analyze the implementation effect of nosocomial infection control measures, so as to provide reference for infection control. Methods An investigation of the prevalence rate of nosocomial infections was performed on patients who were admitted in West China Hospital of Sichuan University from 0:00-24:00 on a day of every late June from 2012 to 2018 by using bedside investigation in combination with inpatient medical record query, and the data was verified, summarized, and statistically analyzed by the professionals of Nosocomial Infection Management Department.Results From 2012 to 2018, the prevalence rates of nosocomial infections were 5.19%, 4.20%, 3.94%, 4.26%, 4.29%,4.25%, and 2.97% in West China Hospital of Sichuan University, which tended to decline(χ~2=32.826, P<0.001). There was no significant difference in annual total infection rate in the Department of Internal Medicine, however, the infection rate in the Department of Hematology tended to decline(χ~2=6.127, P<0.05);in the Department of Surgical Medicine, the total infection rate tended to decline(χ~2=18.721, P<0.001);in particular, the infection rate in the Department of Thoracic Surgery tended to decline(χ~2=3.906, P<0.05);the annual difference in infection rate in the Intensive Care Unit(ICU) was not statistically significant. The key site of nosocomial infection was dominated by the lower respiratory tract, and the annual difference was not statistically significant. In particular, postoperative pneumonia has increased since 2014(χ~2=9.56, P=0.002). The nosocomial pathogens which had the highest constituent ratio over the years were Acinetobacter baumannii(in 2012, 2013, 2014, 2017, and 2018), Klebsiella pneumonia(in 2015), and Escherichia coli(in 2016). The annual difference in rate of antimicrobial use was not statistically significant(χ~2=3.75, P=0.053), while the rate of antimicrobial use in the ICU tended to decline(χ~

关 键 词：医院感染 现患率 趋势分析 

分 类 号：R197.323[医药卫生—卫生事业管理]