某三级医院2010—2021年现患率调查分析  

Investigation and Analysis of Prevalence Rates of Nosocomial Infectionsin a Tertiary Hospital from 2012-2021

作　　者：郑淑蓉 张萍 王新珠[2] ZHENG Shurong;ZHANG Ping;WANG Xinzhu(Department of Hospital Infection Management Section,the Second Hospital of Sanming,Yongan 366000,China;Department of Medical Care,the Second Hospital of Sanming,Yongan 366000,China)

机构地区：[1]福建省三明市第二医院院感科,福建永安366000 [2]福建省三明市第二医院保健科,福建永安366000

出　　处：《中国医药指南》2023年第8期117-121,135,共6页Guide of China Medicine

摘　　要：目的评价医院感染率变化情况,了解医院感染部位分布情况、抗菌药物使用情况等,为确定今后医院感染防控工作重点提供科学依据。方法采用横断面调查法,收集2010—2021年我院住院患者临床资料,采用床旁调查与电子病历调查相结合的方法,对患者医院感染情况进行统计,包括医院感染部位分布及科室分布情况、手术部位感染情况、性别分布、病原菌分布,记录抗菌药物使用情况,使用SPSS 20.0统计软件统计分析。结果12年共调查住院患者8997例,平均医院感染现患率3.92%;下呼吸道感染居首位,手术部位感染中Ⅲ类切口感染率呈上升趋势(趋势性χ^(2)=4.965,P<0.05);医院感染率男性(4.82%)高于女性(2.87%)(P<0.001);年龄分组≥90岁、<10岁、60~89岁组排名前三(P<0.001);医院感染率高发科室为儿科新生儿组、综合ICU、血液病科(组),平均感染率分别为22.73%、20.55%、10.96%;2012—2021年医院感染主要病原菌以革兰阴性菌为主,其中大肠埃希菌、肺炎克雷伯菌排前2名。革兰阳性菌检出数次于革兰阴性菌,以金黄色葡萄球菌、表皮葡萄球菌为主。抗菌药物使用率呈逐年下降的趋势(P<0.001)。结论该研究通过系统分析12年来现患率调查情况,发现下呼吸道是医院感染常见部位,且感染多发于儿科新生儿科、综合ICU、血液病科。老年人与儿童是感染高发群体,病原菌以大肠埃希菌、肺炎克雷伯菌革兰阴性菌为主,应予以高度重视,及时予以抗菌药物预防、治疗,降低感染发生率,增强预后。Objective To evaluate the change of nosocomial infection rate,understand the distribution of nosocomial infection sites and the use of antibiotics,and provide scientific basis for determining the focus of nosocomial infection prevention and measures for control in the future.Methods A cross-sectional survey was conducted on inpatients from 2010 to 2021 by bedside survey and medical records survey,including nosocomial infection site distribution and department distribution,surgical site infection,gender distribution and pathogenic bacteria distribution,and the use of antibiotics was recorded.SPSS 20.0 statistical software was used for statistical analysis.Results A total of 8997 inpatients were investigated in 12 years.The average incidence rate of nosocomial infection was 3.92%.Lower respiratory tract infection was the first,and the infection rate of typeⅢsurgical incision was increasing(χ^(2)=4.965,P<0.05).The nosocomial infection rate of male(4.82%)was higher than that of female(2.87%)(P<0.001).Age group≥90 years old,<10 years old and 60-89 years old ranked the top three(P<0.001).The departments with high incidence of hospital infection rate were pediatric neonatal group,comprehensive ICU and hematology(group),with average infection rate of 22.73%,20.55%and 10.96%,respectively.From 2012 to 2021,the main pathogens of nosocomial infections were Gram-negative bacteria,among which Escherichia coli and Klebsiella pneumoniae ranked first and second.Gram-positive bacteria were less than gram-negative bacteria,Staphylococcus aureus and Staphylococcus epidermidis were the main ones.The utilization rate of antibiotics decreased year by year(P<0.001).Conclusion Through a systematic analysis of the incidence survey in the past 12 years,the study found that the lower respiratory tract was the common site of nosocomial infection,and the infections were mostly in the neonatal department of pediatrics,comprehensive ICU,and hematology department.The elderly and children were the high incidence groups of infection,and the p

关 键 词：医院感染 现患率 感染部位 年龄 性别 抗菌药物 

分 类 号：R63[医药卫生—外科学]