浙江省某县级医院2016-2018年住院患者医院感染监测分析  

Nosocomial infection surveillance in one county hospital in Zhejiang from 2016 to 2018

作　　者：王谦信[1] 姚燕[1] 陆英[1] 余小春[1] 卢斌[1] 樊国芳[1] Wang Qianxin;Yao Yan;Lu Ying;Yu Xiaochun;Lu Bin;Fan Guofang(Department of Infectious Diseases,Chcmgshan County Peopled Hospital,Quzhou 324200,Zhejiang,China)

机构地区：[1]常山县人民医院感染科,浙江衢州324200

出　　处：《国际流行病学传染病学杂志》2021年第2期146-149,共4页International Journal of Epidemiology and Infectious Disease

基　　金：衢州市科技局指导性科技项目(2015119);常山县科技局科技研发和成果转化项目(20150083)。

摘　　要：目的分析浙江省某县级医院2016-2018年住院患者医院感染发生情况和分布特点。方法通过医院临床检验系统和医院感染信息系统,对浙江省某医院2016—2018年住院患者医院感染率、医院感染科室分布、感染部位、感染病原菌及耐药情况进行统计分析。结果2016-2018年共监测住院患者87240例,发生医院感染625例,感染率0.75%,送检560例,送检率89.60%。重症医学科(8.90%,178/2000)发生医院感染率最高。感染部位前3位依次是下呼吸道(37.92%)、泌尿道(20.64%)和上呼吸道(18.56%)。3年间共培养检出病原菌11492株,以革兰阴性菌为主(64.45%),前5位致病菌依次分别为铜绿假单胞菌(17.24%),白假丝酵母菌(10.61%),大肠埃希菌(10.19%),肺炎克雷伯菌(10.16%),金黄色葡萄球菌(7.85%)。铜绿假单胞菌对部分头孢霉素类、复方磺胺甲唑、呋喃妥因等药物耐药率较高(均>98.00%);大肠埃希菌和肺炎克雷伯菌对氨苄西林产生较高的耐药率(83.43%和86.47%);金黄色葡萄球菌对青霉素、红霉素、克林霉素耐药率较高(90.57%、60.19%和51.44%),对利奈唑胺和呋喃妥因敏感。结论该院医院感染率较低,重症医学科是医院感染的高发科室,病原菌以革兰阴性菌为主。基层医院应加强医院感染的预防控制管理,提高病原学送检率,根据药敏结果合理使用抗菌药物。Objective To understand the occurrence and distribution of nosocomial infection in a county-level hospital in Zhejiang from 2016 to 2018.Methods According to the hospital clinical laboratory system and hospital infection information system,the nosocomial infection rate,department distribution,infection site,infection pathogens and drug resistance of inpatients in one hospital in Zhejiang from 2016 to 2018 were statistically analyzed.Results A total of 87240 hospitalized patients were monitored from 2016 to 2018,and 625 patients had hospital infection,with an infection rate of 0.75%.A total of 560 patients were examined,with an examination rate of 89.60%.Intensive medicine department had the highest infection rate(8.90%,178/2000).The top three infection sites were lower respiratory tract(37.92%),urinary tract(20.64%)and upper respiratory tract(18.56%).A total of 11492 strains of pathogenic bacteria were detected in 3 years,with Gram-negative bacteria accounting for 64.45%.The top five pathogenic bacteria were Pseudomonas aeruginosa(17.24%),Candida albicans(10.61%),Escherichia coli(10.19%),Klebsiella pneumoniae(10.16%)and Staphylococcus aureus(7.85%).Pseudomonas aeruginosa showed a high drug resistance rate to some cephalosporins,compound sulfamethoxazole,nitrofurantoin(>98.00%).The drug resistance rates of Escherichia coli and Klebsiella pneumoniae were similar,both of which had high drug resistance rates to ampicillin(83.43%and 86.47%).Staphylococcus aureus had high resistance rates to penicillin,erythromycin and clindamycin(90.57%,60.19%and 51.44%),and no resistance to linezolid and nitrofurantoin.Conclusions The nosocomial infection rate in this hospital is low.The intensive medicine department is the main department with high incidence of hospital infection and Gram-negative bacteria are the main pathogenic bacteria.Strengthening the prevention and control management of hospital infection,increasing the pathogenic inspection rate,and appropriately using antibacterial drugs according to drug sensitivity results

关 键 词：交叉感染 抗菌药物 耐药率 感染病原菌 感染部位 

分 类 号：R197.323[医药卫生—卫生事业管理]