某综合性教学医院连续3年医院感染横断面调查分析
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摘要
目的了解某综合性教学医院的医院感染情况,为该院的院感防控工作提供科学依据。方法采用床旁调查和查阅病历相结合的方法,对该教学医院连续3年医院感染现患率及相关危险因素进行横断面调查。结果 3年共调查住院患者6 766例,实查率为100%;医院感染现患率为2.31%,例次现患率2.56%。呼吸道感染是医院感染最常见的感染部位,占46.81%。年龄35～64岁,65～84岁,留置尿管,机械通气以及留置中央导管是该院医院感染发生的危险因素。革兰氏阴性细菌是该院医院感染的主要病原体,占68.13%。连续3年抗菌药物使用率分别32.12%、35.03%、33.02%;治疗用药送检率分别为62.75%、54.32%、62.96%。结论呼吸道感染是该院最常见的医院感染部位,并且应重点监控有侵入性医疗操作的患者,从而降低该院医院感染的发生。
Objective To investigate the prevalence of nosocomial infection(NI) in a comprehensive teaching hospital,so as to provide preference for NI control.Methods The bed-side survey and hospital records check up were taken to investigate the Nl prevalence rates in inpatients with a cross-sectional method in recent 3 years.Results A total number of 6 766 patients were included.The overall prevalence of inpatients with NI was 2.31 percent(%).Respiratory tract infections(RTI)were the most common infection site(46.81 %).NI occurrences were significantly associated with age 35-64 years,age 65-84 years,indwelling urinary catheter,mechanical ventilation and central/peripheral intravascular catheter.Gram-negative bacteria were the most isolated pathogens in our surveys(68.13%).Antibiotics use rate in 2015,2016,2017 were administered to 32.12%,35.03%,33.02%,respectively.62.75%,54.32%,62.96% of inpatients who received antimicrobial agents were delivered samples for pathogenic detcetion.Conclusion Respiratory tract infection is the most common site of nosocomial infection in the hospital,and should focus on monitoring patients with invasive medical procedures,thereby reducing the incidence of nosocomial infections in the hospital.
Objective To investigate the prevalence of nosocomial infection(NI) in a comprehensive teaching hospital,so as to provide preference for NI control.Methods The bed-side survey and hospital records check up were taken to investigate the Nl prevalence rates in inpatients with a cross-sectional method in recent 3 years.Results A total number of 6 766 patients were included.The overall prevalence of inpatients with NI was 2.31 percent(%).Respiratory tract infections(RTI)were the most common infection site(46.81 %).NI occurrences were significantly associated with age 35-64 years,age 65-84 years,indwelling urinary catheter,mechanical ventilation and central/peripheral intravascular catheter.Gram-negative bacteria were the most isolated pathogens in our surveys(68.13%).Antibiotics use rate in 2015,2016,2017 were administered to 32.12%,35.03%,33.02%,respectively.62.75%,54.32%,62.96% of inpatients who received antimicrobial agents were delivered samples for pathogenic detcetion.Conclusion Respiratory tract infection is the most common site of nosocomial infection in the hospital,and should focus on monitoring patients with invasive medical procedures,thereby reducing the incidence of nosocomial infections in the hospital.
引文
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[14] WHO.Report on the Burden of Endemic Health Care-Associated Infection Worldwide[R].2011.
[15] Jroundi I,Khoudri I,Azzouzi A,et al.Prevalence of hospital-acquired infection in a Moroccan university hospital[J].American Journal of Infection Control,2007,35(6):412-416.
[16] Klavs I,Bufon Luznik T,Skerl M,et al.Prevalance of and risk factors for hospital-acquired infections in Slovenia-results of the first national survey,2001[J].Journal of Hospital Infection,2003,54(2):149-157.
[17] Hunter JD.Ventilator associated pneumonia[J].British Medical Journal,2012,344(1):e3325-e3325.
[18] Warren JW.Catheter-associated urinary tract infections[J].International Journal of Antimicrobial Agents,2001,17(4):299-303.
[19] Anon.Vital signs:central line-associated blood stream infections--United States,2001,2008,and 2009[J].Morbidity and Mortality Weekly Report,2011,60(8):243-248.
[20] Li C,Ren N,Wen X,et al.Changes in antimicrobial use prevalence in China:results from five point prevalence studies[J].PloS one,2013,8(12):e82785.
[21] 国家卫生计生委.卫医发[2015]43号抗菌药物临床应用指导原则[S].北京,2015.
[2] 王鑫姝,孙丽静,付燕,等.医院感染现患率调查对目标性监测的意义[J].中华医院感染学杂志,2013,23(13):3059-3061.
[3] 中华人民共和国卫生部[WS/T 312-2009]医院感染监测规范[S].北京,2009.
[4] 中华人民共和国卫生部.卫医发[2001]2号医院感染感染诊断标准(试行)[S].北京,2001.
[5] 张满,牟霞,杨怀,等.2014年贵州省65885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.
[6] 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.
[7] 范珊红,金霞,吕桂枝,等.综合性医院医院感染患病率及危险因素调查[J].中国感染控制杂志,2010,9(4):245-247.
[8] 陈黎媛,牟霞,杨怀,等.2014年贵州省某三甲医院医院感染横断面调查分析[J].现代预防医学,2015,42(19):3602-3605.
[9] 李金梅,李家斌,王进.综合医院医院感染横断面调查分析[J].中华医院感染学杂志,2015,25(1):102-104.
[10] Tao XB,Qian LH,Li Y,et al.Hospital-acquired infection rate in a tertiary care teaching hospital in China:a cross-sectional survey involving 2434 inpatients[J].International Journal of Infectious Diseases,2014,27:7-9.
[11] Zhang Y,Fu XY,Wang HF,et al.Annual surveys for point-prevalence of healthcare-associated infection in a tertiary hospital in Beijing,China,2012-2014[J].BMC Infectious Diseases,2016,16:161.
[12] Lanini S,Jarvis WR,Nicastri E,et al.Healthcare-Associated Infection in Italy Annual Point-Prevalence Surveys,2002–2004[J].Infection Control & Hospital Epidemiology,2015,30(7):659-665.
[13] Gikas A,Pediaditis J,Papadakis JA,et al.Prevalence study of hospital-acquired infections in 14 Greek hospitals:planning from the local to the national surveillance level[J].Journal of Hospital Infection,2002,50(4):269-275.
[14] WHO.Report on the Burden of Endemic Health Care-Associated Infection Worldwide[R].2011.
[15] Jroundi I,Khoudri I,Azzouzi A,et al.Prevalence of hospital-acquired infection in a Moroccan university hospital[J].American Journal of Infection Control,2007,35(6):412-416.
[16] Klavs I,Bufon Luznik T,Skerl M,et al.Prevalance of and risk factors for hospital-acquired infections in Slovenia-results of the first national survey,2001[J].Journal of Hospital Infection,2003,54(2):149-157.
[17] Hunter JD.Ventilator associated pneumonia[J].British Medical Journal,2012,344(1):e3325-e3325.
[18] Warren JW.Catheter-associated urinary tract infections[J].International Journal of Antimicrobial Agents,2001,17(4):299-303.
[19] Anon.Vital signs:central line-associated blood stream infections--United States,2001,2008,and 2009[J].Morbidity and Mortality Weekly Report,2011,60(8):243-248.
[20] Li C,Ren N,Wen X,et al.Changes in antimicrobial use prevalence in China:results from five point prevalence studies[J].PloS one,2013,8(12):e82785.
[21] 国家卫生计生委.卫医发[2015]43号抗菌药物临床应用指导原则[S].北京,2015.