2015-2017年精神专科医院感染与抗菌药物使用现状调查
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摘要
目的了解2015-2017年精神专科医院感染现患率与抗菌药物使用状况,分析医院感染与抗菌药物变化趋势,为医院感染防控提供参考。方法采用床旁与病历调查相结合的方法对2015年1月-2017年12月精神专科医院内各科室住院的精神病患者1 356例进行横断面调查。结果发生医院感染患者41例,现患率为3.02%。男性与女性医院感染现患率分别为2.84%(18/634)、3.19%(23/722);≥65岁,18～64岁,<18岁医院感染现患率为6.12%(15/245)、2.54%(17/668)、2.03%(9/443),差异有统计学意义(P=0.007);老年病区医院感染现患率为6.25%(11/176)高于急病区和身心病区1.89%(8/424)、1.63%(4/246)(P=0.005、0.011);2015-2017年患者医院感染现患率分别为2.97%(/12/404)、2.90%(13/448)、3.17%(16/504)。医院感染患者中上呼吸道感染25例,下呼吸道感染8例,皮肤感染5例。抗菌药物使用率为9.37%(127/1 356),各年龄段及病区患者抗菌药物使用率差异有统计学意义(P<0.001);2015年、2016年、2017年患者抗菌药物使用率分别为10.64%、9.38%、8.33%。使用抗菌药物目的其中治疗88例,预防19例,治疗+预防20例;单一用药112例,联合用药15例。结论2015-2017年精神专科医院医院感染现患率与抗菌药物使用率均较低,医院感染与抗菌药物使用主要集中在老年及慢性病区,连续3年医院感染部位、抗菌药物使用目的及种类无明显变化。
OBJECTIVE To understand the prevalence rates of nosocomial infection and antimicrobial use rates in a psychiatric hospital during 2015-2017,so as to analyze the trends of nosocomial infection and antibacterial drugs,and provide reference for preventing and controlling nosocomial infection.METHODS The cross-sectional surveys on prevalence rates of nosocomial infection and antimicrobial use among 1356 cases of hospitalized patients in the hospital from Jan 2015 to Dec 2017 were carried out by combination of bedside investigation and reviewing of medical record.RESULTS There were 41 cases of nosocomial infection,with a prevalence rate of 3.02%.The prevalence rates of nosocomial infection in male and female patients were 2.84%(18/634)and 3.19%(23/722),respectively.The prevalence rates of nosocomial infection in patients of>65 years old,18-64 years old,< 18 years old were 6.12%(15/245),2.54%(17/668),2.03%(9/443),respectively,and the difference was significant(P= 0.007).The prevalence rate of nosocomial infection in geriatric ward was 6.25%(11/176),significantly higher than those in acute and psychosomatic wards,which were 1.89%(8/424)and 1.63%(4/246)(P=0.005 and0.011),respectively.The prevalence rates of nosocomial infection in 2015-2017 were 2.97%(12/404),2.90%(13/448)and 3.17%(16/504),respectively.Among the patients with nosocomial infection,25 cases were upper respiratory tract infection,8 cases were lower respiratory tract infection and 5 cases were skin infection.The use rate of antibiotics was 9.37%(127/1 356),and there was a significant difference in the use rate of antibiotics among different age groups and wards(P <0.001).In 2015,2016 and 2017,the use rate of antibiotics was10.64%,9.38%and 8.33%,respectively.Among them,88 cases were aimed to treat infections,19 cases were aimed to prevent infections,20 cases were aimed to both treat and prevent infections,112 cases were treated with a certain single drug and 15 cases were treated with drug combinations.CONLCUSION The prevalence rates of nosocomial infection and antimicrobial use rates in 2015-2017 maintained at a low level in the hospital.Geriatric and chronic disease wards were the main departments with nosocomial infection and antimicrobial use.There were no significant differences in the infection sites,antimicrobial use purposes and types in the there consecutive years.
OBJECTIVE To understand the prevalence rates of nosocomial infection and antimicrobial use rates in a psychiatric hospital during 2015-2017,so as to analyze the trends of nosocomial infection and antibacterial drugs,and provide reference for preventing and controlling nosocomial infection.METHODS The cross-sectional surveys on prevalence rates of nosocomial infection and antimicrobial use among 1356 cases of hospitalized patients in the hospital from Jan 2015 to Dec 2017 were carried out by combination of bedside investigation and reviewing of medical record.RESULTS There were 41 cases of nosocomial infection,with a prevalence rate of 3.02%.The prevalence rates of nosocomial infection in male and female patients were 2.84%(18/634)and 3.19%(23/722),respectively.The prevalence rates of nosocomial infection in patients of>65 years old,18-64 years old,< 18 years old were 6.12%(15/245),2.54%(17/668),2.03%(9/443),respectively,and the difference was significant(P= 0.007).The prevalence rate of nosocomial infection in geriatric ward was 6.25%(11/176),significantly higher than those in acute and psychosomatic wards,which were 1.89%(8/424)and 1.63%(4/246)(P=0.005 and0.011),respectively.The prevalence rates of nosocomial infection in 2015-2017 were 2.97%(12/404),2.90%(13/448)and 3.17%(16/504),respectively.Among the patients with nosocomial infection,25 cases were upper respiratory tract infection,8 cases were lower respiratory tract infection and 5 cases were skin infection.The use rate of antibiotics was 9.37%(127/1 356),and there was a significant difference in the use rate of antibiotics among different age groups and wards(P <0.001).In 2015,2016 and 2017,the use rate of antibiotics was10.64%,9.38%and 8.33%,respectively.Among them,88 cases were aimed to treat infections,19 cases were aimed to prevent infections,20 cases were aimed to both treat and prevent infections,112 cases were treated with a certain single drug and 15 cases were treated with drug combinations.CONLCUSION The prevalence rates of nosocomial infection and antimicrobial use rates in 2015-2017 maintained at a low level in the hospital.Geriatric and chronic disease wards were the main departments with nosocomial infection and antimicrobial use.There were no significant differences in the infection sites,antimicrobial use purposes and types in the there consecutive years.
引文
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[13]杨骅,韩志云,杨亮蕊,等.抗菌药物合理应用对临床抗菌药物使用率及院内感染率的影响观察[J].临床合理用药杂志,2015(8):81-82.
[14]张思兵,刘运喜,杜明梅,等.住院患者抗菌药物使用率与医院感染发病率变化的趋势分析[J].中华医院感染学杂志,2018,28(12):1768-1773.
[2]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.
[3] Choi JY,Kwak YG,Yoo H,et al.Trends in the incidence rate of device-associated infections in intensive care units after the establishment of the Korean Nosocomial Infections Surveillance System[J].J Hosp Infect,2015,91(1):28-34.
[4]劳一群,曾娟,柳剑,等.2010-2014年医院感染现患率调查分析[J].中华医院感染学杂志,2017,27(2):443-447.
[5]郭凤玲,温世宝,任南,等.2013-2015年60所中医院医院感染现患率调查分析[J].中华医院感染学杂志,2016,26(21):4913-4915.
[6] Al-Mousa HH,Omar AA,Rosenthal VD,et al.Device-associated infection rates,bacterial resistance,length of stay,and mortality in Kuwait:International Nosocomial Infection Consortium findings[J].Am J Infect Control,2016,44(4):444-449.
[7] Ramirez-Wong FM,Atencio-Espinoza T,Rosenthal VD,et al.Surgical site infections rates in more than 13,000surgical procedures in three cities in Peru:findings of the International Nosocomial Infection Control Consortium[J].Surg Infect,2015,16(5):572-576.
[8]申俊萍,杨芸,薛平.山西省2012-2016年医院感染现患率及抗菌药物使用变化趋势及分析[J].现代医院管理,2017,15(2):5-8.
[9] Gonzalez Ramallo VJ,Miron Rubio M,Estrada Cuxart O.Usefulness of Hospital at Home in nosocomial infections:advantages and limitations[J].Rev Esp Quimioter,2017,30(Suppl 1):61-65.
[10] Xia J,Gao J,Tang W.Nosocomial infection and its molecular mechanisms of antibiotic resistance[J].Biosci Trends,2016,10(1):14-21.
[11] Dalton BR,Sabuda DM,Bresee LC,et al.Assessment of antimicrobial utilization metrics:days of therapy versus defined daily doses and pharmacy dispensing records versus nursing administration data[J].Infect Control Hosp Epidemiol,2015,36(6):688-694.
[12] Petchwattana N,Naknaen P.Utilization of thymol as an antimicrobial agent for biodegradable poly(butylene succinate)[J].Mater Chem Phys,2015:S0254058415302455.
[13]杨骅,韩志云,杨亮蕊,等.抗菌药物合理应用对临床抗菌药物使用率及院内感染率的影响观察[J].临床合理用药杂志,2015(8):81-82.
[14]张思兵,刘运喜,杜明梅,等.住院患者抗菌药物使用率与医院感染发病率变化的趋势分析[J].中华医院感染学杂志,2018,28(12):1768-1773.