论文部分内容阅读
目的了解市级医疗单位医院感染现况,为制定高危人群、高危环节的医院感染防控措施提供依据。方法按照2013年成都市医院感染质量控制中心对医院感染横断面调查的要求,对成都市第二人民医院2013年7月25日所有住院患者进行调查,并对结果进行统计学分析。结果应调查1 307例,实际调查1 301例,实查率99.54%,医院感染现患率为3.38%(44例)。感染率前5位科室分别为呼吸重症监护病房、中心重症监护病房、神经外科、胸外科和普外科。感染部位主要为呼吸道感染,占62.26%。单因素分析结果显示,年龄≥60岁、住院时间>2周、有侵入性操作、有糖尿病史、进行手术和放射/化学治疗、使用抗菌药物是医院感染的高危因素;多因素分析显示,住院时间(OR=3.115,P=0.001)、侵入性操作(OR=14.930,P<0.001)、糖尿病(OR=2.157,P=0.046)、放射/化学治疗(OR=7.497,P<0.001)是医院感染独立危险因素。所有住院患者中抗菌药物使用率为45.73%,其中一联用药占85.21%,治疗性用药占82.18%。结论了解医院感染的现况有助于市级医院掌握医院感染防控的重点和难点,制定针对高危人群、高危科室、高危环节的防控措施,并指导和督促临床科室落实,为进一步降低医院感染发生率指引方向。
Objective To understand the current status of nosocomial infection in municipal medical units and provide evidence for the prevention and control of nosocomial infections in high-risk groups and high-risk sectors. Methods According to the requirements of the cross-sectional investigation on nosocomial infection in 2013 in Chengdu Hospital of Infection Quality Control Center, all inpatients in Chengdu Second People’s Hospital on July 25, 2013 were investigated and the results were statistically analyzed. Results A total of 1 307 cases should be investigated. The actual investigation was 1 301 cases, the actual examination rate was 99.54% and the prevalence rate of hospital infection was 3.38% (44 cases). The top five infection rates were respiratory intensive care unit, central ICU, neurosurgery, thoracic surgery and general surgery. Infections were mainly respiratory tract infections, accounting for 62.26%. Univariate analysis showed that patients aged ≥60 years and hospital stay> 2 weeks had invasive procedures and had a history of diabetes mellitus, surgery and radiotherapy / chemotherapy. The use of antibacterials was a high risk factor for nosocomial infections. Multivariate analysis showed that hospitalization (OR = 3.115, P = 0.001), invasive surgery (OR = 14.930, P <0.001), diabetes mellitus (OR = 2.157, P = 0.046) and radiation / chemotherapy Infection with independent risk factors. The antibacterial drug use rate was 45.73% in all inpatients, of which 85.21% were combined with one drug and 82.18% with therapeutic drug. Conclusion Understanding the current status of nosocomial infection can help municipal hospitals to master the key points and difficulties in prevention and control of nosocomial infections. They should make prevention and control measures for high-risk groups, high-risk departments and high-risk sectors and guide and supervise the implementation of clinical departments. The incidence of infection guides the direction.