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目的调查中国近30年医院感染暴发事件发生情况及其流行病学特征。方法通过文献检索,对1980年1月-2009年12月发生的医院感染暴发事件进行回顾性分析。结果检索近30年国内医院感染暴发事件共352起,感染7 656人,病死341人。感染病原体以细菌、病毒为主,占91.48%;主要传播途径为接触传播(44.32%)、医源性传播(43.18%);夏季医院感染暴发事件发生概率最高(35.51%,125/352);婴幼儿是感染暴发事件中的最大受害者(占43.99%),新生儿病死率达84.58%(192/227);普通级医院(省、市、县级医院)是感染暴发事件的高发区(73.58%,259/352);感染部位主要为肠道(32.07%)、下呼吸道(26.19%)、血液系统(14.07%);医务人员手交叉感染、血液制品污染、消毒隔离措施不到位、违反操作规程等是感染事件暴发的主要原因。结论医院感染的发生有一定规律可循,应针对其暴发流行的特征制定干预措施,有效预防、控制感染的暴发。
Objective To investigate the incidence and epidemiological characteristics of nosocomial outbreaks in China in recent 30 years. Methods A retrospective analysis of nosocomial infection outbreaks occurred from January 1980 to December 2009 was conducted through literature search. Results A total of 352 domestic outbreaks of nosocomial infections were reported in the recent 30 years, with 7,656 infections and 341 fatalities. Infectious pathogens were mainly bacteria and viruses, accounting for 91.48%. The main routes of transmission were contact transmission (44.32%) and iatrogenic transmission (43.18%). The highest incidence of nosocomial infection outbreaks in summer was 35.51% (125/352) Infants and young children were the biggest victims of outbreaks (43.99%) and neonatal mortality rates were 84.58% (192/227). Ordinary hospitals (provincial, municipal and county-level hospitals) were the high incidence areas of outbreaks 73.58%, 259/352). The main infection sites were intestinal tract (32.07%), lower respiratory tract (26.19%) and hematological system (14.07%). Cross-infection of medical staff, contamination of blood products and disinfection and isolation were not in place. Operating procedures is the main reason for the outbreak of infection. Conclusion The occurrence of nosocomial infection has some rules to follow. Outbreaks should be based on the characteristics of its outbreaks of interventions to effectively prevent and control the outbreak of infection.