重庆某三甲医院2011年—2017年住院患者医院感染现患率调查*

Prevalence rates of nosocomial infections and variation trends from 2011 to 2017 in a hospital*

摘要:

目的 了解重庆市某三甲医院住院患者医院感染现患率及其变化趋势，为有效预防和控制医院感染提供科学依据。方法 采用横断面调查的方法，从2011年—2017年连续7年对重庆市涪陵中心医院住院患者医院感染现患率进行调查与分析。结果 7年共调查住院患者8?663例，发生医院感染427例、483例次，感染现患率为4.93%、例次感染率为5.58%；7年感染科室均以重症医学科等为主；感染部位以下呼吸道为主；病原微生物检出率67.68%，前5位病原微生物以鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、真菌为主，其中大肠埃希菌的检出率呈下降趋势，肺炎克雷伯菌和鲍曼不动杆菌的检出率呈上升趋势；抗菌药物平均使用率为30.77%，预防性用药比例呈下降趋势，联合用药均以一联单用为主。结论 在横断面调查的基础上，要加强临床医师对相关专业知识的培训，增强医务人员医院感染预防控制的观念，做好监测工作，健全监测制度，完善监测体系，使医院感染率控制在较低水平。

Abstract:

Objective To investigate the prevalence rates and variation trends of nosocomial infection so as to provide scientific evidence for effective prevention and control of nosocomial infection in a hospital of Chongqing. Methods A cross-sectional survey was conducted to investigate the nosocomial infection of prevalence in inpatients in the hospital for seven consecutive years from 2011 to 2017. All data were statistically analyzed using SPSS 21.0 software. Results A total of 8,663 cases of hospitalized patients were investigated during the 7-year period; 427 (483 case-times) had nosocomial infections with 4.93% prevalence rate of infection and 5.58% case-time infection rate of infection. The nosocomial infections were most prevalent in the Department of Critical Care Medicine during 7 years; the lower respiratory tract was dominated in infection sites; the detection rate of pathogenic microorganisms was 67.68%, and the top five pathogenic microorganisms were Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Fungus. Among them, the detection of Escherichia coli showed a downward trend. The detection of Klebsiella pneumoniae and Acinetobacter baumannii showed an upward trend; the average use rate of antibiotics was 30.77%, and the proportion of preventive drugs showed a downward trend. Combination drugs are mainly on a single use. Conclusions Based on the cross-sectional survey, it is necessary to strengthen the training of clinicians for related professional knowledge, strengthen the concept of hospital infection prevention and control for medical personnel, do a good job of monitoring, improve the monitoring system, and improve the monitoring system so that the hospital infection rate can be controlled. Low level.