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目的了解某院2014年医院感染现状,为医院感染的控制与管理提供科学依据。方法选择2014年8月14日00:00-24:00住院患者,采用床旁调查与病历调查相结合的方法对住院患者的感染情况进行横断面调查,填写调查表,对各科室患者的医院及社区感染相关数据进行统计分析。结果共监测1 908例患者,医院感染现患率为4.45%,社区感染患病率为29.09%。医院感染率最高的科室为综合重症监护病房(38.10%),外科系统排名前3位的科室为胸外科(18.67%)、普外科(16.67%)、神经外科(10.53%),内科系统排名前3位的科室为内分泌科(11.11%)、神经内科(6.67%)、感染科(5.88%)。社区感染率居于前3位的科室分别为儿科(非新生儿组)(95.37%)、烧伤外科(92.31%)、呼吸内科(86.46%)。医院感染和社区感染感染部位主要为下呼吸道(58.24%)。感染检出病原菌主要为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌、铜绿假单胞菌,医院感染与社区感染的细菌谱一致,抗菌药物使用率40.82%;其中预防用药126例(6.60%),治疗用药599例(31.39%),治疗用药患者细菌培养送检率80.71%,送检阳性率43.78%。结论可进一步有针对性地制定监测方案,从而降低医院感染率。
Objective To understand the status of nosocomial infection in a hospital in 2014 and provide a scientific basis for the control and management of nosocomial infection. Methods The hospitalized patients were enrolled in this study from October 00, 2014 to January 24, 2014. A cross-sectional survey of inpatients' infections was conducted by using a combination of bedside survey and medical records. Fill in the questionnaire, And community infection-related data for statistical analysis. Results A total of 1 908 patients were monitored. The prevalence rate of hospital infection was 4.45% and the prevalence of community infection was 29.09%. The departments with the highest hospital infection rates were general intensive care unit (38.10%), the top three surgical departments were thoracic surgery (18.67%), general surgery (16.67%), neurosurgery (10.53%), The three departments were endocrinology (11.11%), neurology (6.67%) and infection (5.88%). Community infection rate among the top three departments were pediatric (non-neonatal group) (95.37%), burn surgery (92.31%), respiratory medicine (86.46%). Nosocomial infections and community-acquired infections were mainly lower respiratory tract (58.24%). The main pathogens detected were Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, and the nosocomial infections were consistent with those of community-acquired infections. The antibacterial drug use rate was 40.82% Among them, 126 cases (6.60%) were preventive drugs and 599 cases (31.39%) were used for treatment. The rate of bacterial culture in treatment patients was 80.71% and the positive rate was 43.78%. Conclusions Surveillance programs can be further targeted to reduce hospital infection rates.