湘雅医院15年间医院感染现患率调查
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吴安华

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R181.3+2

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湖南省卫生计生委课题(B2016107)


Survey on prevalence of healthcareassociated infection in Xiangya Hospital in 15 years
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    摘要:


    [摘要]目的了解湘雅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。方法采用床旁调查与病历调查相结合的横断面调查方法,调查该院2000—2014年(2006年未进行)某一日所有住院患者的医院感染现患率、横断面抗菌药物使用率及细菌培养送检率。结果2000—2014年医院感染现患率从6.30%降低至3.91%,差异有统计学意义(χ2=35.14,P<0.001);社区感染现患率为15.61%~15.76%,各年度比较,差异无统计学意义。医院感染现患率最高的科室为综合重症监护病房(ICU);医院感染与社区感染均以下呼吸道感染居首位;泌尿道置管率呈下降趋势,动静脉置管率呈上升趋势,差异均有统计学意义(χ2值分别为5.21、96.24,均P<0.001)。2008—2014年治疗性使用抗菌药物患者病原体送检率为36.37%~44.51%,医院感染病例病原体送检率为34.00%~44.99%,医院感染病原体检出率为41.57%~68.48%,均呈增长趋势,差异均有统计学意义(χ2值分别为22.78、10.03、26.49,均P<0.001)。感染病原体以革兰阴性(G-)菌为主;抗菌药物横断面使用率与联合用药率均呈下降趋势,差异均有统计学意义(P<0.05)。结论该院医院感染防控与抗菌药物管理取得初步成效,医院感染现患率与抗菌药物横断面使用率均明显下降,感染病原体以G-菌为主,感染部位以下呼吸道居首位。

    Abstract:

    ObjectiveTo investigate the prevalence rate of healthcareassociated infection(HAI) in Xiangya Hospital,and provide reference for preventing and controlling HAI.MethodsThe cross sectional surveys on prevalence rates of HAI, crosssectional antimicrobial use, and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006) were carried out by combination of bedside investigation and medical record reviewing.ResultsThe prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%, difference was statistically significant (χ2=35.14,P<0.001); prevalence rates of communityassociated infection(CAI)were 15.61%-15.76%, there was no significant difference among each year. General intensive care unit (ICU) had the highest prevalence rate; respiratory tract was the most common site of both HAI and CAI; urinary catheterization rate showed a decreased tendency, arteriovenous catheterization rate showed a increased tendency, difference were both significant(χ2=5.21,96.24,respectively, both P<0.001). In 2008-2014, pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency, difference was significant (χ2=22.78, 10.03,26.49, respectively, all P<0.001). Gramnegative bacteria were the main pathogens causing infection; both cross sectional and combination antimicrobial usage rates declined (P<0.05).ConclusionPrevention and control of HAI,and antimicrobial management has achieved preliminary success, prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously, the main pathogen is gramnegative bacteria,and the major infection site is lower respiratory tract.

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引用本文

曾翠,任南,黄勋,等.湘雅医院15年间医院感染现患率调查[J]. 中国感染控制杂志,2016,15(6):367-373. DOI:10.3969/j. issn.1671-9638.2016.06.002.
ZENG Cui, REN Nan, HUANG Xun, et al. Survey on prevalence of healthcareassociated infection in Xiangya Hospital in 15 years[J]. Chin J Infect Control, 2016,15(6):367-373. DOI:10.3969/j. issn.1671-9638.2016.06.002.

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  • 收稿日期:2016-01-25
  • 最后修改日期:2016-02-12
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  • 在线发布日期: 2016-06-30
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