2014-2018年新疆生产建设兵团地区医院感染横断面调查
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摘要
目的了解新疆生产建设兵团地区各级医院抗菌药物使用、病原微生物检出及医院感染发生情况,为修订本地区院内感染防治措施提供科学依据。方法采用横断面调查方法,依据全国医院感染监控管理培训基地医院感染现患率调查方案,对新疆兵团地区2014、2016及2018年某调查日医疗机构所有患者进行统一调查,对调查结果进行比较分析。结果 2014、2016、2018年医院感染例次发病率分别为2.24%、1.54%、1.71%,呈下降趋势(P<0.001);感染率前三位的科室分别是综合ICU、新生儿科、神经外科;医院感染部位居前四位的是下呼吸道、上呼吸道、表浅切口、泌尿道;医院感染病原菌以肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌为主;三次调查平均抗菌药物使用率分别为28.02%、24.87%、27.87%,差异有统计学意义(P<0.05)。结论医院感染横断面调查可基本反映目前新疆生产建设兵团地区医院感染管理存在的问题,为有效开展兵团各级医院目标监测,控制医院感染提供依据。
OBJECTIVE To understand the use of antimicrobial drugs,detection of pathogenic microorganisms and incidence of nosocomial infections in hospitals at all levels in Xinjiang Production and Construction Corps Area,and to provide scientific basis for the formulation of measures to prevent and treat nosocomial infection in the region.METHODS By means of cross-sectional survey,according to the Nosocomial Infection Prevalence Investigation Program of the National Nosocomial Infection Control and Management Training Base,a unified survey was conducted for all of the patients who were hospitalized in medical institutions of Xinjiang Production and Construction Corps Area on the survey day of 2014,2016 and 2018,and the results of the survey were observed and compared.RESULTS The incidence of nosocomial infections in 2014,2016,and 2018 was 2.24%,1.54%,and1.71%,respectively,with significant differences(P<0.001)and showing a downward trend.The top three departments of the infection rate were comprehensive ICU,neonatal pediatrics,and neurosurgery.The top four sites of nosocomial infections were the lower respiratory tract,upper respiratory tract,superficial incision,and urinary tract.The top three pathogens detected in hospitals were Klebsiella pneumoniae,Escherichia coli,and Acinetobacter baumannii.The average use rate of antimicrobial drugs in the three surveys was 28.02%,24.87%,and27.87,respectively,and the difference was significant(P<0.05).CONCLUSION The cross-sectional survey of nosocomial infection can basically reflect the existing problems in the management of nosocomial infection in Xinjiang Production and Construction Corps Area,and provide evidence for the effective monitoring of hospital targets at all levels of the XPCC area and the control of nosocomial infection.
OBJECTIVE To understand the use of antimicrobial drugs,detection of pathogenic microorganisms and incidence of nosocomial infections in hospitals at all levels in Xinjiang Production and Construction Corps Area,and to provide scientific basis for the formulation of measures to prevent and treat nosocomial infection in the region.METHODS By means of cross-sectional survey,according to the Nosocomial Infection Prevalence Investigation Program of the National Nosocomial Infection Control and Management Training Base,a unified survey was conducted for all of the patients who were hospitalized in medical institutions of Xinjiang Production and Construction Corps Area on the survey day of 2014,2016 and 2018,and the results of the survey were observed and compared.RESULTS The incidence of nosocomial infections in 2014,2016,and 2018 was 2.24%,1.54%,and1.71%,respectively,with significant differences(P<0.001)and showing a downward trend.The top three departments of the infection rate were comprehensive ICU,neonatal pediatrics,and neurosurgery.The top four sites of nosocomial infections were the lower respiratory tract,upper respiratory tract,superficial incision,and urinary tract.The top three pathogens detected in hospitals were Klebsiella pneumoniae,Escherichia coli,and Acinetobacter baumannii.The average use rate of antimicrobial drugs in the three surveys was 28.02%,24.87%,and27.87,respectively,and the difference was significant(P<0.05).CONCLUSION The cross-sectional survey of nosocomial infection can basically reflect the existing problems in the management of nosocomial infection in Xinjiang Production and Construction Corps Area,and provide evidence for the effective monitoring of hospital targets at all levels of the XPCC area and the control of nosocomial infection.
引文
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[11]Tao XB,Qian L H,Li Y,et al.Hospital-acquired infection rate in a tertiary care teaching hospital in china;a cross-sectional survey involving 2434inpatients[J].Int Infect Dis,2014,27:7-9.
[12]Kim JM,Park ES,Jeong JS,et al.Multicenter surveillance study for nosocomial infections in major hospitals in Korea.Nosocomial Infection Surveillance Committee of the Korean Society for Nosocomial Infection Control[J].Am J Infect Control,2000,28(6):454-458.
[13]Severijnen AJ,Verbrugh HA,Mintjes-de Groot AJ,et al.Sentinel system for nosocomial infections in The Netherlands:apilot study[J].Infect Control Hosp Epidemiol,1997,18(12):818-824.
[14]Starling CE,Couto BR,Pinheiro SM.Applying the centers for Disease Control and Prevention and National Nosocomial Surveillance system methods in Brazilian hospitals[J].Am JInfect Control,1997,25(4):303-311.
[15]Magill SS,Edwards JR,Bamberg W,et al.Multistate point-prevalence survey of health care-associated infections[J].NEngl J Med,2014,370(13):1198-1208.
[16]Prakash D,Saxena RS.Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of meerut city,India[J].Isrn Microbiology,2013,2013:749629.
[17]Kang CI,Song JH.Antimicro resistance in Asia:current epidemiology and clinical implycations[J].Infect Chemother,2013,45(1):22-31.
[18]任南,文细毛,吴安华.2014年全国医院感染横断面调查报告[J].中国感染控制杂志,2016,15(2):83-87.
[19]Charrier L,Argentero PA,Farina EC,et al.Surveillance of healthcare-associated infections in Piemonte,Italy:results from a second regional prevalence study[J].BMC Public Health,2014,14(1):558.
[20]张新颖,王占国,杜凤芹,等.某综合三级医院3年医院感染现患率调查分析[J].医学研究与教育,2018,35(4):40-45.
[21]Liu JY,Wu YH,Cai M,et al.Point-prevalence survey of healthcare-associated infection in Beijing,China:a survey and analysis in 2014[J].J Hosp Infect,2016,93(3):271-279.
[22]谭军,周爱军,翁晓芳,等.不同级别医疗机构医院感染横断面研究[J].华西医学,2018,33(3):1-5.
[23]刘小丽,龚林,梁建生,等.2016年武汉市33所医疗机构医院感染横断面调查[J].中国消毒学杂志,2017,34(12):1141-1144.
[24]Behnke M,Hansen S,Leistner R,et al.Nosocomial infection and antibiotic use:a second national prevanlence study in Germany[J].Dtsch Arztebl Int,2013,110(38):627-633.
[2]商丽妍,吴菲,李海峰,等.沈阳市四所综合医院3年医院感染现患率调查[J].中华医院感染学杂志,2018,28(13):2049-2052.
[3]韩阳,潘海峰,范引光,等.某三甲医院2010-2014年住院患者医院感染现患率调查研究[J].中华疾病控制杂志,2016,20(1):58-62.
[4]宫雅琪,谭莉,刘晓丽,等.武汉地区2010-2014年医院感染横断面调查研究[J].中华医院感染学杂志,2018,28(13):2044-2048.
[5]江敏,袁可欣,江敏,等.2016年大庆市医院感染现患率调查分析[J].中华医院感染学杂志,2018,28(6):946-848.
[6]Tammelin A,Qvarfordt I.Point-prevalance surveillance of healthcare-associated infections in Swedish hospital,2008-2014.Description of the method and reliability of results[J].JHosp Infect,2015,91(3):220-224.
[7]Zarb P,Coignard B,Griskeviciene J,et al.The European Centre for Disease Prevention and Control(EC-DC)pilot point prevalence survey of healthcare-associated infections and auti-microbial use[J].Euro Surveill,2012,17(46):202316.
[8]Reilly J,Cairns S,Fleming S,et al.Results from the second Scottish national prevalence survey:the changing epidemiology of healthcare-associated infection in Scotland[J].J Hosp Infect,2012,82(3):170-174.
[9]Thu TA,Hung NV,Quang NN,et al.A point-prevalence study on healthcare-associated infection in Vietnam:public health implications[J].Infect Control Hosp Epidemiol,2011,32(10):1039-1041.
[10]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[11]Tao XB,Qian L H,Li Y,et al.Hospital-acquired infection rate in a tertiary care teaching hospital in china;a cross-sectional survey involving 2434inpatients[J].Int Infect Dis,2014,27:7-9.
[12]Kim JM,Park ES,Jeong JS,et al.Multicenter surveillance study for nosocomial infections in major hospitals in Korea.Nosocomial Infection Surveillance Committee of the Korean Society for Nosocomial Infection Control[J].Am J Infect Control,2000,28(6):454-458.
[13]Severijnen AJ,Verbrugh HA,Mintjes-de Groot AJ,et al.Sentinel system for nosocomial infections in The Netherlands:apilot study[J].Infect Control Hosp Epidemiol,1997,18(12):818-824.
[14]Starling CE,Couto BR,Pinheiro SM.Applying the centers for Disease Control and Prevention and National Nosocomial Surveillance system methods in Brazilian hospitals[J].Am JInfect Control,1997,25(4):303-311.
[15]Magill SS,Edwards JR,Bamberg W,et al.Multistate point-prevalence survey of health care-associated infections[J].NEngl J Med,2014,370(13):1198-1208.
[16]Prakash D,Saxena RS.Distribution and antimicrobial susceptibility pattern of bacterial pathogens causing urinary tract infection in urban community of meerut city,India[J].Isrn Microbiology,2013,2013:749629.
[17]Kang CI,Song JH.Antimicro resistance in Asia:current epidemiology and clinical implycations[J].Infect Chemother,2013,45(1):22-31.
[18]任南,文细毛,吴安华.2014年全国医院感染横断面调查报告[J].中国感染控制杂志,2016,15(2):83-87.
[19]Charrier L,Argentero PA,Farina EC,et al.Surveillance of healthcare-associated infections in Piemonte,Italy:results from a second regional prevalence study[J].BMC Public Health,2014,14(1):558.
[20]张新颖,王占国,杜凤芹,等.某综合三级医院3年医院感染现患率调查分析[J].医学研究与教育,2018,35(4):40-45.
[21]Liu JY,Wu YH,Cai M,et al.Point-prevalence survey of healthcare-associated infection in Beijing,China:a survey and analysis in 2014[J].J Hosp Infect,2016,93(3):271-279.
[22]谭军,周爱军,翁晓芳,等.不同级别医疗机构医院感染横断面研究[J].华西医学,2018,33(3):1-5.
[23]刘小丽,龚林,梁建生,等.2016年武汉市33所医疗机构医院感染横断面调查[J].中国消毒学杂志,2017,34(12):1141-1144.
[24]Behnke M,Hansen S,Leistner R,et al.Nosocomial infection and antibiotic use:a second national prevanlence study in Germany[J].Dtsch Arztebl Int,2013,110(38):627-633.