2016-2018年某三甲医院住院患者医院感染现患率调查分析
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摘要
目的了解某三甲医院住院患者医院感染的实际情况及变化趋势,为有效预防与控制医院感染提供依据。方法采用床旁调查和病历调查相结合的横断面调查方法,对该院2016-2018年某一日0∶00-24∶00所有住院患者进行医院感染及相关因素调查。结果 2016-2018年医院感染总现患率为3.02%,例次现患率为3.42%。医院感染总现患率居前三位的科室依次为重症医学一科、重症医学二科、神经外一科和血液科,各科室医院感染现患率差异有统计学意义(P<0.05)。医院感染部位居前三位的依次为下呼吸道、上呼吸道和呼吸机相关性肺炎。总抗菌药物使用率为24.83%,三年抗菌药物使用率呈逐年下降趋势(P<0.05),总治疗用药送检率为73.91%,三年治疗用药送检率呈先升高又下降趋势(P<0.05)。泌尿道插管、使用有创呼吸机、气管切开、置管引流、糖尿病、使用放化疗药物、脑梗死或脑出血是医院感染的危险因素。结论 2016-2018年该院感染现患率在控制范围内,感染较重的为重症科室,以呼吸道感染为主,抗菌药物使用率和治疗用药送检率有下降趋势,医务人员应着重从泌尿道插管、使用有创呼吸机、气管切开、置管引流、糖尿病、使用放化疗药物、脑梗死或脑出血等危险因素上采取相应的预防控制措施,以降低医院感染发生率。
Objective The actual situation and changing trend of nosocomial infection were investigated in a third-grade class-A hospital, so as to provide evidence for effective prevention and control of nosocomial infection. Methods The nosocomial infection and related factors among all inpatients in the hospital from 0∶00 am to 24∶00 pm on a certain day were investigated by using across-sectional survey method of clinical study and medical record, from 2016 to 2018. Results The total nosocomial infection prevalence rate from 2016 to 2018 was 3.02%, and the case-time prevalence rate was 3.42%; there were three departments showed the highest total prevalence rate of the nosocomial infection: ICU, Neurosurgery Department, and Hematology Department(P<0.05); The top three nosocomial infection sites were: lower respiratory tract(48/51.61%), upper respiratory tract(8/8.60%), VAP(8/8.60%); The total utilization rate of antibiotics was 24.83% although the utilization rate of antibiotics was decreasing(P<0.05). The total bacteria examination rate for therapeutic antibiotics was 73.91%, and the rate increased in the beginning then decreased in the end(P<0.05) in three years; Urinary intubation, tracheotomy, drainage, diabetes, chemoradiotherapy, cerebral infarction or cerebral hemorrhage were risk factors of nosocomial infection. Conclusion From 2016 to 2018, the prevalence of infection in the hospital was under control. Severe infections were found in critical departments,respiratory tract infection is the main cause. The usage rate of antibiotics and the delivery rate of therapeutic drugs had a downward trend. Medical staff should take corresponding preventive and control measures from the risk factors of urinary intubation, use of invasive ventilator, tracheotomy, catheter drainage, diabetes mellitus, use of radiotherapy and chemotherapy drugs, cerebral infarction or cerebral hemorrhage to reduce the incidence of nosocomial infection.
Objective The actual situation and changing trend of nosocomial infection were investigated in a third-grade class-A hospital, so as to provide evidence for effective prevention and control of nosocomial infection. Methods The nosocomial infection and related factors among all inpatients in the hospital from 0∶00 am to 24∶00 pm on a certain day were investigated by using across-sectional survey method of clinical study and medical record, from 2016 to 2018. Results The total nosocomial infection prevalence rate from 2016 to 2018 was 3.02%, and the case-time prevalence rate was 3.42%; there were three departments showed the highest total prevalence rate of the nosocomial infection: ICU, Neurosurgery Department, and Hematology Department(P<0.05); The top three nosocomial infection sites were: lower respiratory tract(48/51.61%), upper respiratory tract(8/8.60%), VAP(8/8.60%); The total utilization rate of antibiotics was 24.83% although the utilization rate of antibiotics was decreasing(P<0.05). The total bacteria examination rate for therapeutic antibiotics was 73.91%, and the rate increased in the beginning then decreased in the end(P<0.05) in three years; Urinary intubation, tracheotomy, drainage, diabetes, chemoradiotherapy, cerebral infarction or cerebral hemorrhage were risk factors of nosocomial infection. Conclusion From 2016 to 2018, the prevalence of infection in the hospital was under control. Severe infections were found in critical departments,respiratory tract infection is the main cause. The usage rate of antibiotics and the delivery rate of therapeutic drugs had a downward trend. Medical staff should take corresponding preventive and control measures from the risk factors of urinary intubation, use of invasive ventilator, tracheotomy, catheter drainage, diabetes mellitus, use of radiotherapy and chemotherapy drugs, cerebral infarction or cerebral hemorrhage to reduce the incidence of nosocomial infection.
引文
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[4] 王宝涵,李伟,庞来祥.医院感染现患率调查[J].中华医院感染学杂志,2013,23(13):3062-3063.
[2] 中华人民共和国卫生部.医院管理评价指南[S].北京,2008:5.
[3] 尹丹萍,何多多,巩霞,等.某三甲医院2014-2016年医院感染现患率调查分析[J].中华医院感染学杂志,2017,27(6):1405-1408.
[4] 王宝涵,李伟,庞来祥.医院感染现患率调查[J].中华医院感染学杂志,2013,23(13):3062-3063.