2014年贵州省医疗机构住院患者医院感染和社区感染现患率调查
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摘要
目的了解贵州省医疗机构住院患者医院感染与社区感染现状,以及抗菌药物使用情况。方法 2014年9月对贵州省174所二级及二级以上医疗机构住院患者感染情况进行横断面调查。结果共调查68 419例住院患者,实查率为99.65%。发生医院感染1 581例、1 684例次,医院感染现患率为2.31%、例次现患率为2.46%,发生社区感染18 571例、19 191例次,社区感染现患率为27.14%、例次现患率为28.05%;医院感染和社区感染现患率最高的科室分别为综合ICU、儿科非新生儿组。医院感染部位和社区感染部位比较差异有统计学意义(χ2=17 325.44,P<0.01);医院感染和社区感染的病原菌均以大肠埃希菌为主。调查日抗菌药物使用率为39.82%,使用率最高的为综合ICU(80.47%)和儿科(76.67%)。用药目的以治疗用药为主[18 386例(67.48%)],联合用药以单一用药为主[21 672例(79.55%)]。治疗使用抗菌药物者病原菌培养送检率为31.76%。结论此次调查有助于了解贵州省医院感染和社区感染高发科室、高发部位,以及治疗使用抗菌药物患者病原学送检情况,为进一步的预防与控制医院感染提供依据。
Objective To investigate the current status of healthcare-associated infection(HAI),community-associated infection(CAI),and antimicrobial use in hospitalized patients in medical institutions of Guizhou Province.Methods In September 2014,infection status of hospitalized patients in 174 second level hospitals and above in Guizhou Province were performed cross-sectional survey.Results A total of 68 419 patients were surveyed,the actual survey rate was 99.65%.1 581 patients developed 1 684 cases of HAI,HAI prevalence rate and HAI case prevalence rate were 2.31% and 2.46% respectively,18 571 patients developed 19 191 cases of HAI,CAI prevalence rate and CAI case prevalence rate were 27.14% and 28.05% respectively;patients in general intensive care unit(ICU)and pediatric department(non-neonatal group)had the highest HAI and CAI prevalence rates respectively.Constituent ratios of HAI and CAI sites was significantly different(χ2=17 325.44,P<0.01);Escherichia coli was the main pathogen causing HAI and CAI.Utilization rate of antimicrobial agents on the survey day was39.82%,ICU(80.47%)and pediatric department(76.67%)were the highest.Therapeutic antimicrobial use accounted for 67.48%(n=18 386),single antimicrobial use accounted for 79.55%(n=21 672).Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 31.76%.Conclusion This survey is helpful for understanding the high risk departments and sites of HAI and CAI in Guizhou Province,as well as pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents,which provides basis for further prevention and control of HAI.
Objective To investigate the current status of healthcare-associated infection(HAI),community-associated infection(CAI),and antimicrobial use in hospitalized patients in medical institutions of Guizhou Province.Methods In September 2014,infection status of hospitalized patients in 174 second level hospitals and above in Guizhou Province were performed cross-sectional survey.Results A total of 68 419 patients were surveyed,the actual survey rate was 99.65%.1 581 patients developed 1 684 cases of HAI,HAI prevalence rate and HAI case prevalence rate were 2.31% and 2.46% respectively,18 571 patients developed 19 191 cases of HAI,CAI prevalence rate and CAI case prevalence rate were 27.14% and 28.05% respectively;patients in general intensive care unit(ICU)and pediatric department(non-neonatal group)had the highest HAI and CAI prevalence rates respectively.Constituent ratios of HAI and CAI sites was significantly different(χ2=17 325.44,P<0.01);Escherichia coli was the main pathogen causing HAI and CAI.Utilization rate of antimicrobial agents on the survey day was39.82%,ICU(80.47%)and pediatric department(76.67%)were the highest.Therapeutic antimicrobial use accounted for 67.48%(n=18 386),single antimicrobial use accounted for 79.55%(n=21 672).Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 31.76%.Conclusion This survey is helpful for understanding the high risk departments and sites of HAI and CAI in Guizhou Province,as well as pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents,which provides basis for further prevention and control of HAI.
引文
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[3]许川,徐敏,梁艳芳,等.75所医院医院感染现患率调查及危险因素分析[J].现代预防医学,2015,42(12):2266-2268.
[4]吴安华,文细毛,李春辉,等.2012年全国医院感染现患率与横断面抗菌药物使用率调查报告[J].中国感染控制杂志,2014,13(1):8-15.
[5]陈松华,王晓萌,夏时畅.影响肺结核病人疾病负担的多因素分析[J].中国卫生经济,2007,26(2):58-61.
[6]Zarh P,Coignard B,Griskeviciene J,et al.The European Centre for Disease Prevention and Control(ECDC)pilot point prevalence survey of healthcare-associated infections and antimicrobial[J].Euro Surveill,2012,17(46):1-16.
[7]方旭,王志荣,杨晋红,等.某综合医院住院患者医院感染和社区感染现患率调查[J].现代预防医学,2012,39(18):4713-4715.
[8]向钱,魏道琼,周忠华,等.2011年四川省248所医院医院感染横断面调查[J].中国感染控制杂志,2013,12(3):186-189,210.
[9]林澜溪,杨永洁,余金泉,等.医院感染现患率调查分析[J].中华医院感染学杂志,2014,24(7):1655-1657.
[10]张满,牟霞,杨怀,等.2014年贵州省65 885例住院患者医院感染横断面调查[J].现代预防医学,2015,42(16):3040-3044.
[11]王洪梅,胡新林,徐惠霞,等.住院患者医院感染现患率调查与分析[J].中华医院感染学杂志,2016,26(1):204-206.
[12]Magill SS,Edwards JR,Bamberg WA,et al.Multistate point-prevalence survey of health care-associated infections[J].N Engl J Med,2014,370(13):1198-1208.
[13]宛传丹,周金保,马月琴,等.医院感染铜绿假单胞菌危险因素与预防策略分析[J].现代预防医学,2015,42(1):172-174.
[14]吕欣,赵静,孙洁敏,等.内科住院患者医院感染的病原菌种类及耐药性分析[J].现代预防医学,2015,42(4):737-739.
[15]刘卫平,田勇泉,郑志楠,等.2014年医院感染现患率调查分析[J].中华医院感染学杂志,2015,25(21):4894-4896,4964.
[16]吴艳艳,高芳,邹俊宁,等.某医院2014年住院患者医院感染现患率调查[J].中国消毒学杂志,2015,32(11):1104-1106.
[17]黄文治,庄红娣,李诗雨,等.2011年四川省23所医院抗菌药物使用情况调查与分析[J].华西医学,2014,29(3):404-408.
[18]Ansari F,Erntell M,Uoossens H,et al.The European surveillance of antimicrobial consumption(ESAC)point-prevalence survey of antibacterial use in 20 European hospitals in2006[J].Clin Infect Dis,2009,49(10):1496-1504.
[2]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.
[3]许川,徐敏,梁艳芳,等.75所医院医院感染现患率调查及危险因素分析[J].现代预防医学,2015,42(12):2266-2268.
[4]吴安华,文细毛,李春辉,等.2012年全国医院感染现患率与横断面抗菌药物使用率调查报告[J].中国感染控制杂志,2014,13(1):8-15.
[5]陈松华,王晓萌,夏时畅.影响肺结核病人疾病负担的多因素分析[J].中国卫生经济,2007,26(2):58-61.
[6]Zarh P,Coignard B,Griskeviciene J,et al.The European Centre for Disease Prevention and Control(ECDC)pilot point prevalence survey of healthcare-associated infections and antimicrobial[J].Euro Surveill,2012,17(46):1-16.
[7]方旭,王志荣,杨晋红,等.某综合医院住院患者医院感染和社区感染现患率调查[J].现代预防医学,2012,39(18):4713-4715.
[8]向钱,魏道琼,周忠华,等.2011年四川省248所医院医院感染横断面调查[J].中国感染控制杂志,2013,12(3):186-189,210.
[9]林澜溪,杨永洁,余金泉,等.医院感染现患率调查分析[J].中华医院感染学杂志,2014,24(7):1655-1657.
[10]张满,牟霞,杨怀,等.2014年贵州省65 885例住院患者医院感染横断面调查[J].现代预防医学,2015,42(16):3040-3044.
[11]王洪梅,胡新林,徐惠霞,等.住院患者医院感染现患率调查与分析[J].中华医院感染学杂志,2016,26(1):204-206.
[12]Magill SS,Edwards JR,Bamberg WA,et al.Multistate point-prevalence survey of health care-associated infections[J].N Engl J Med,2014,370(13):1198-1208.
[13]宛传丹,周金保,马月琴,等.医院感染铜绿假单胞菌危险因素与预防策略分析[J].现代预防医学,2015,42(1):172-174.
[14]吕欣,赵静,孙洁敏,等.内科住院患者医院感染的病原菌种类及耐药性分析[J].现代预防医学,2015,42(4):737-739.
[15]刘卫平,田勇泉,郑志楠,等.2014年医院感染现患率调查分析[J].中华医院感染学杂志,2015,25(21):4894-4896,4964.
[16]吴艳艳,高芳,邹俊宁,等.某医院2014年住院患者医院感染现患率调查[J].中国消毒学杂志,2015,32(11):1104-1106.
[17]黄文治,庄红娣,李诗雨,等.2011年四川省23所医院抗菌药物使用情况调查与分析[J].华西医学,2014,29(3):404-408.
[18]Ansari F,Erntell M,Uoossens H,et al.The European surveillance of antimicrobial consumption(ESAC)point-prevalence survey of antibacterial use in 20 European hospitals in2006[J].Clin Infect Dis,2009,49(10):1496-1504.