某三级中医院住院患者医院感染病例调查分析  

Investigation and Analysis of Nosocomial Infection Cases among Inpatients in a Certain Tertiary Traditional Chinese Medicine Hospital

作　　者：张妍 陈晓君 陈红[2] ZHANG Yan;CHEN Xiaojun;CHEN Hong(Department of Infection Management,Nantong Traditional Chinese Medicine Hospital;Department of Infection Management,Affiliated Hospital of Nantong University,Nantong,Jiangsu,226001)

机构地区：[1]南通市中医院感染管理科 [2]南通大学附属医院感染管理科,江苏南通226001

出　　处：《江苏卫生事业管理》2022年第3期334-337,343,共5页Jiangsu Health System Management

基　　金：江苏省医院协会医院管理创新研究项目(JSYGY-3-2020-187);南通市卫生和计划生育委员会科研项目(QA2020066);南通大学附属医院院级课题(Tfg1904)。

摘　　要：目的:调查分析某三级中医院住院患者感染病例,系统掌握医院感染的相关数据,为该中医院医院感染管理工作可持续发展提供科学依据。方法:对2019年9月至2021年9月入住某三级中医院住院患者进行回顾性研究,并对发生医院感染的病例进行统计学汇总分析。结果:2019年9月至2021年9月共监测住院患者58013人,发生医院感染491例次,医院感染例次率为0.85%,年龄越高,医院感染率越高,且不同年龄组患者医院感染率有统计学差异(P<0.01);呼吸系统感染例次率(0.36%)最高,其次为泌尿系统感染(感染例次率为0.20%),按医院片区划分,内科片科室医院感染例次率(1.55%)最高,其次为外科片科室(感染例次率为0.55%);医院感染病原菌以革兰阴性菌为主,占74.33%,主要为肺炎克雷伯菌、大肠埃希菌;其次为革兰阳性菌,占18.51%,主要为金黄色葡萄球菌、表皮葡萄球菌;真菌占7.16%;多重耐药菌占医院感染病原菌25.37%,以多耐药的鲍曼不动杆菌(MDRAB)、耐甲氧西林的金黄色葡萄球菌(MRSA)、多耐药的铜绿假单胞菌(MDRPA)为主,其检出率分别为68%、62.5%、55.56%。结论:本研究客观真实地反映了某三级中医院医院感染率、高危感染部位、高发科室、医院感染病原菌情况,为今后针对性开展目标性监测工作提供了有力的依据。Objective:By investigating and analyzing the infection cases of inpatients in a certain tertiary traditional Chinese medicine(TCM)hospital,we can systematically grasp the relevant data of nosocomial infection,so as to provide a scientific basis for the sustainable development of the nosocomial infection management in this TCM hospital.Methods:A retrospective study was conducted on inpatients admitted to acertain tertiary traditional Chinese medicine hospital from September 2019 to September 2021,and a statistical summary analysis of the cases of nosocomial infection was conducted.Results:From September 2019 to September 2021,a total of 58,013 hospitalized patients were monitored,and 491 nosocomial infections occurred,with a nosocomial infection rate of 0.85%.The higher the age,the higher the nosocomial infection rate,and the nosocomial infection rate of patients in different age groups was statistically different(P<0.01).Respiratory system infection rate(0.36%)was the highest,followed by urinary system infection(infection rate was0.20%).The department of internal medicine has the highest infection rate(1.55%),followed by the department of surgery(0.55%).Nosocomial infection pathogens were mainly Gram-negative bacteria,accounting for 74.33%,mainly Klebsiella pneumoniae and Escherichia coli;followed by Gram-positive bacteria,accounting for 18.51%,mainly Staphylococcus aureus and Staphylococcus epidermidis;Fungi accounted for 7.16%.Multidrug-resistant bacterial infections accounted for 25.37%of nosocomial pathogens,with multidrugresistant Acinetobacter baumannii(MDRAB),methicillin-resistant Staphylococcus aureus(MRSA),multidrug-resistant Pseudomonas aeruginosa(MDRPA),the detection rates were 68%,62.5%,and 55.56%,respectively.Conclusions:This study objectively and truly reflects the nosocomial infection rate,high-risk infection sites,high-incidence departments,and nosocomial pathogenic bacteria in a certaintertiary TCM hospital,and can provide a strong basis for targeted monitoring work in the future.

关 键 词：三级中医院 医院感染 病原菌 预防与控制 

分 类 号：R197.39[医药卫生—卫生事业管理]