2020-2022年云南地区住院患者医院感染现患率调查  

Healthcare-associated infection prevalence rate among hospitalized patients in Yunnan area from 2020 to 2022

作　　者：范丽[1,2] 张丽娟 张慧[1,2] FAN Li;ZHANG Li-juan;ZHANG Hui(Department of Infection Management,The First People’s Hospital of Yunnan Province,Kunming 650000,China;Healthcare-associated Infection Quality Control Center of Yunnan Province,Kunming 650000,China)

机构地区：[1]云南省第一人民医院感染管理科,云南昆明650000 [2]云南省医院感染质量控制中心,云南昆明650000

出　　处：《中国感染控制杂志》2024年第9期1142-1149,共8页Chinese Journal of Infection Control

摘　　要：目的了解2020-2022年云南地区住院患者医院感染现状,为优化相应的防控措施提供参考资料。方法通过云南省医院感染质量控制中心监测系统收集2020-2022年云南地区医院感染现患率调查(横断面调查)上报的数据,汇总后应用SPSS 25.0软件进行统计分析。结果2020-2022年分别调查患者117695、109691、137188例,医院感染现患率分别为1.58%、1.47%、1.29%,差异有统计学意义(χ^(2)=36.853,P<0.001);感染部位以下呼吸道(2526例次,43.60%)和泌尿道(785例次,13.55%)为主;三次现患率调查综合重症监护病房(ICU)均是医院感染现患率最高的科室(10.95%~16.47%);医院感染病原体主要以革兰阴性菌为主,其中大肠埃希菌均居首位,肺炎克雷伯菌次之,而革兰阳性菌以金黄色葡萄球菌为主;患者抗菌药物使用率为30.96%~33.91%,呈上升趋势(χ^(2)=257.586,P<0.001);抗菌药物使用目的以治疗为主(占76.46%~78.62%);抗菌药物使用以一联用药为主,三联及以上用药略有升高,从0.66%上升至0.98%;治疗性使用抗菌药物病原学送检率呈上升趋势(χ^(2)=94.823,P<0.001)。Ⅰ类切口手术患者手术部位感染率为0.77%~1.22%,三年Ⅰ类切口手术患者抗菌药物预防性使用率分别为19.40%、19.11%、20.93%,差异均有统计学意义(χ^(2)值分别为94.823、10.179,均P=0.006)。结论云南地区住院患者医院感染现患率虽有所下降,但医院感染病原体的防控和Ⅰ类切口手术患者预防性抗菌药物的合理使用将是今后工作的重点和难点。Objective To understand the current situation of healthcare-associated infection(HAI)among hospitalized patients in Yunnan area from 2020 to 2022,and provide reference for optimizing corresponding prevention and control measures.Methods Data of HAI prevalence rate survey(cross-sectional survey)in Yunnan area from 2020 to 2022 were collected through Yunnan Provincial HAI Quality Control Center Surveillance System,and su-mmarized.Statistical analysis was performed with SPSS 25.0 software.Results From 2020 to 2022,117695,109691,and 137188 patients were surveyed respectively,and the prevalence rates of HAI were 1.58%,1.47%,and 1.29%,respectively,with statistically significant difference(χ^(2)=36.853,P<0.001).Lower respiratory tract(n=2526,43.60%)and urinary tract(n=785,13.55%)were the major infection sites.General intensive care unit(ICU)had the highest HAI prevalence rate(10.95%-16.47%)in all three prevalence surveys.The main pathogens causing HAI were Gram-negative bacteria,with Escherichia coli being the first,followed by Klebsiella pneumoniae,while the major Gram-positive bacteria was Staphylococcus aureus.Antimicrobial use rates in patients were 30.96%-33.91%,showing an upward trend(χ^(2)=257.586,P<0.001).The main purpose of antimicrobial use was for treatment(accounting for 76.46%-78.62%).Antimicrobial use was mainly single use,with a slight increase in combined use of three antimicrobials and above,increasing from 0.66%to 0.98%.The pathogenic detection rate for therapeutic antimicrobial use showed an upward trend(χ^(2)=94.823,P<0.001).Surgical site infection rates in patients undergoing classⅠincision surgery were 0.77%-1.22%;the prophylactic antimicrobial use rates in patients undergoing classⅠincision surgery in three years were 19.40%,19.11%,and 20.93%,respectively,both with statistically significant difference(χ^(2)=94.823,10.179,both P=0.006).Conclusion The prevalence rate of HAI among hospitalized patients in Yunnan area has decreased,however,the prevention and control of HAI pathogens,as well as

关 键 词：医院感染 现患率 病原体 抗菌药物 

分 类 号：R197.323.4[医药卫生—卫生事业管理]