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目的调查内、外科医院与社区感染的现患情况。方法采用横断面调查方法,调查2015年河北省253所医院内、外科医院与社区感染现患率、病原菌检出以及抗菌药物使用情况。结果共调查65 065例患者,内外科医院感染现患率分别为2.7%与3.2%,社区感染现患率分别为21.3%与10.5%,差异有统计学意义(P<0.001)。感染部位中前3位,外科医院感染为下呼吸道、手术部位与泌尿道,社区感染为皮肤软组织、腹腔内组织与泌尿道;内科均为下呼吸道、上呼吸道与泌尿道。医院感染中,内科产超广谱β-内酰胺酶/耐碳青霉烯肺炎克雷伯菌与耐甲氧西林金黄色葡萄球菌检出率分别为44.6%与20.5%,外科分别为22.7%与42.2%,差异均有统计学意义(P<0.05);社区感染中,内科各多重耐药菌检出率均显著高于外科(P<0.05)。内外科抗菌药物使用率分别为24.4%与44.6%,内科93.0%为治疗用药,外科53.6%为预防用药,差异有统计学意义(P<0.05)。结论内外科医院与社区感染在感染部位、多重耐药菌检出、抗菌药物使用等方面均有差异,应加强感染的监控和病原菌送检。
Objective To investigate the prevalence of infection in internal and external hospitals and community. Methods The cross-sectional survey method was used to investigate the prevalence rate of pathogens and the use of antimicrobial agents in the hospitals and community hospitals in Hebei Province in 2015. Results A total of 65 065 patients were surveyed. The prevalence rates of infection in internal and external hospitals were 2.7% and 3.2% respectively. The prevalence rates of community infection were 21.3% and 10.5% respectively, with statistical significance (P <0.001). Infection site in the first three, surgical hospital infection for the lower respiratory tract, surgical site and the urinary tract, community-based infection of the skin and soft tissue, abdominal tissue and urinary tract; internal medicine are lower respiratory tract, upper respiratory tract and urinary tract. Among the nosocomial infections, the detection rates of ESBLs - / carbapenema - resistant Klebsiella pneumoniae and methicillin - resistant Staphylococcus aureus were 44.6% and 20.5% respectively in the hospital, and 22.7% And 42.2% respectively (P <0.05). In community infection, the detection rate of multiple drug-resistant bacteria was significantly higher than that of surgery (P <0.05). The usage rate of internal and external antibiotics was 24.4% and 44.6% respectively, 93.0% in medicine and 53.6% in surgery, respectively. The difference was statistically significant (P <0.05). Conclusion There are differences in the infection sites, multi-drug resistant bacteria detection, antibacterial drug use between the internal and external hospitals and community-based infections, and the surveillance of infection and the submission of pathogens should be strengthened.