某县级市中医医院2015—2017年感染资料分析
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摘要
目的了解某县级市中医医院2015—2017年医院感染情况,为制定有效的干预措施提供科学依据。方法收集2015—2017年全部出院患者的病例资料和医院感染报告卡,采用描述性流行病学方法对感染率、发生科室、感染部位和病原菌等资料进行分析。结果 2015—2017年共54 198例患者出院,发生医院感染1 805例,1 903例次,年均感染率为3.33%,年均例次感染率为3.51%,感染率呈逐年下降趋势(χ■=13.435,P<0.01);男女性别比为1.04∶1,男女间感染率差异无统计学意义(P>0.05);医院感染的主要危险因素为气管插管、泌尿道插管和化疗,感染率分别为13.26%、9.76%、6.87%。院感率前三位的科室分别为ICU(10.56%)、肿瘤内科(5.37%)和呼吸内科(5.35%);感染部位以下呼吸道感染为主(30.37%);2015—2017年院内抗菌药物使用率分别为49.60%、44.37%和32.61%,呈逐年下降趋势(χ■=1 094.450,P<0.01);病原学送检率分别为25.00%、30.90%和36.79%,呈逐年上升趋势(χ■=174.426,P<0.01);感染病原菌以大肠埃希菌(32.69%)、肺炎克雷伯菌(18.49%)和铜绿假单胞菌(12.58%)为主。结论该院2015—2017年感染发生率和抗菌药物使用率逐年下降,病原标本送检率逐年上升,但仍未达标,需提高医务人员送检意识,根据结果合理使用抗生素。
Objective To investigate and analyze the current situation of nosocomial infection in a county-level hospital of traditional Chinese medicine from 2015 to 2017,provide scientific basis for the formulation of effective intervention measures.Methods We collected the case records and nosocomial infection report cards of discharged patients from 2015 to 2017.Descriptive epidemiological method was used to analyze the hospitality infection ratio,occurrence departments,infection sites and pathogens.Results Among 54 198 hospitalized patients,1 805 cases and 1 903 times of hospital infection occurred,with the average infection rate of 3.33% and case-time rate of 3.51%.The infection rates showed a declining trend year by year(χ~2_(trend)=13.435,P<0.01).The male to female ratio of the cases was 1.04∶1,the difference did not have significance(P>0.05).Risk factors for nosocomial infection in the top three were trachea cannule,urinary catheter and chemotherapy,accounting for 13.26%,9.76% and 6.87%.The top three departments of hospital infection were ICU(10.56%),medical oncology(5.37%) and respiratory medicine department(5.35%).The most common infection sites was the lower respiratory tract,accounting for 30.37%.The rates of antibacterial drug use were 49.60%,44.37% and 32.61%,with a declining trend year by year(χ~2_(trend)=1094.450,P<0.01).The rates of etiological examination were 25.00%,30.90% and 36.79%,showed an increasing trend year by year(χ~2_(trend)=174.426,P<0.01).The most common pathogens were Escherichia coli(32.69%),Klebsiella pneumoniase(18.49%)and pseudomona(12.58%).Conclusion The rate of nosocomial infection of the hospital and the usage rate of antibiotics have decreased,the rate of etiological examination has increased,but it is fail to reach the standard.It is necessary to improve the awareness of medical personnel for inspection,and rational use of antibiotics according to the results.
Objective To investigate and analyze the current situation of nosocomial infection in a county-level hospital of traditional Chinese medicine from 2015 to 2017,provide scientific basis for the formulation of effective intervention measures.Methods We collected the case records and nosocomial infection report cards of discharged patients from 2015 to 2017.Descriptive epidemiological method was used to analyze the hospitality infection ratio,occurrence departments,infection sites and pathogens.Results Among 54 198 hospitalized patients,1 805 cases and 1 903 times of hospital infection occurred,with the average infection rate of 3.33% and case-time rate of 3.51%.The infection rates showed a declining trend year by year(χ~2_(trend)=13.435,P<0.01).The male to female ratio of the cases was 1.04∶1,the difference did not have significance(P>0.05).Risk factors for nosocomial infection in the top three were trachea cannule,urinary catheter and chemotherapy,accounting for 13.26%,9.76% and 6.87%.The top three departments of hospital infection were ICU(10.56%),medical oncology(5.37%) and respiratory medicine department(5.35%).The most common infection sites was the lower respiratory tract,accounting for 30.37%.The rates of antibacterial drug use were 49.60%,44.37% and 32.61%,with a declining trend year by year(χ~2_(trend)=1094.450,P<0.01).The rates of etiological examination were 25.00%,30.90% and 36.79%,showed an increasing trend year by year(χ~2_(trend)=174.426,P<0.01).The most common pathogens were Escherichia coli(32.69%),Klebsiella pneumoniase(18.49%)and pseudomona(12.58%).Conclusion The rate of nosocomial infection of the hospital and the usage rate of antibiotics have decreased,the rate of etiological examination has increased,but it is fail to reach the standard.It is necessary to improve the awareness of medical personnel for inspection,and rational use of antibiotics according to the results.
引文
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[3] 蒙巍,金宗英,骆丽平,等.2014-2016年某中医医院现患率调查分析[J].中华医院感染学杂志,2017,27(4):823-826.
[4] 余淑霞,许婷,马鸿云.2013-2017年医院感染现患率调查分析[J].中华医院感染学杂志,2018,28(8):1175-1178.
[5] 倪玲美,戴新娥,莫军军,等.使用清洗消毒剂清洗呼吸机管路的消毒效果及影响因素[J].浙江预防医学,2015,27(1):84-85,88.
[6] 王月华.2011年某医院8995例住院患者医院感染调查分析[J].中国民康医学,2013,52(4):95-96.
[7] 周美儿,叶玲,王玲露,等.某县级中医院感染资料分析[J].浙江预防医学,2018,30(5):485-489.
[8] 任冬梅,李德保,田春梅,等.2013-2015年某三级综合医院感染现患率调查分析[J].河南预防医学杂志,2018,29(2):112-114.
[9] Tammelin A,Qvarfordt I.Point-prevalence surveillance of healthcare-associated infection in Swedish hospital,2008-2014.Description of the meethod and reliability of results[J].J Hosp Infect,2015,91(3):220-224.
[10] Mancini A,Verdini D,La Vigna G,et al.Retrospective analysis of nosocomial in an Italian teriary care hospital[J].New Microbiol,2016,39(3):197-205.
[2] 中华人民共和国卫生部.医院感染诊断标准[S].北京:中国人民共和国卫生部,2001.
[3] 蒙巍,金宗英,骆丽平,等.2014-2016年某中医医院现患率调查分析[J].中华医院感染学杂志,2017,27(4):823-826.
[4] 余淑霞,许婷,马鸿云.2013-2017年医院感染现患率调查分析[J].中华医院感染学杂志,2018,28(8):1175-1178.
[5] 倪玲美,戴新娥,莫军军,等.使用清洗消毒剂清洗呼吸机管路的消毒效果及影响因素[J].浙江预防医学,2015,27(1):84-85,88.
[6] 王月华.2011年某医院8995例住院患者医院感染调查分析[J].中国民康医学,2013,52(4):95-96.
[7] 周美儿,叶玲,王玲露,等.某县级中医院感染资料分析[J].浙江预防医学,2018,30(5):485-489.
[8] 任冬梅,李德保,田春梅,等.2013-2015年某三级综合医院感染现患率调查分析[J].河南预防医学杂志,2018,29(2):112-114.
[9] Tammelin A,Qvarfordt I.Point-prevalence surveillance of healthcare-associated infection in Swedish hospital,2008-2014.Description of the meethod and reliability of results[J].J Hosp Infect,2015,91(3):220-224.
[10] Mancini A,Verdini D,La Vigna G,et al.Retrospective analysis of nosocomial in an Italian teriary care hospital[J].New Microbiol,2016,39(3):197-205.