摘要
目的探讨综合性医院的医院感染和病原菌分布情况,为预防与控制医院感染提供科学依据。方法对2010-2012年出院的患者医院感染情况进行回顾性调查分析。结果发生医院感染4 007例,感染率为2.69%,感染例次4 430,感染例次率2.97%。医院感染率居首位的科室为ICU病房,侵袭性操作如泌尿道插管、呼吸机等是医院感染的重要因素。本调查显示4个季度医院感染在例数上无明显差异,但主要易感部位上呼吸道、下呼吸道、泌尿道的季节变化差异有统计学意义(P<0.05),医院感染病原菌以革兰阴性菌为主,占61.14%,革兰阳性菌占15.54%,大肠埃希菌的分离率最高。大肠埃希菌、克雷伯菌的分离率在三、四季度较一、二季度有明显升高。对临床上最常见金黄色葡萄球菌与大肠埃希菌的耐药率变化分析显示,部分抗生素的总体耐药率变化差异有统计学意义。结论通过对医院感染的流行病学调查和监测,可以发现医院感染变化的趋势及医院感染控制的关键点,针对重点科室、危险因素、易感人群加强管理和目标监测,可有效降低医院感染的发生。
Objective Pathogen distribution and hospital infection in general hospital were explored by trend analysis, in order to provide scientific theory for prevention and control of hospital infection. Methods Prospective and retrospective survey methods were combined to analyze the hospital infection of 148 940 patients admitted to the hospital from 2010 to 2012. Results A total of 4 430 infection cases （2.97%） occurred in 4 007 patients （2.69%）. The department with the highest nosocomial infection rate is the ICU ward. Invasive operations such as urinary tract catheter and ventilator are important factors for nosocomial infections. The present survey data showed that the numbers of nosocomial infections were not significantly different among the four seasons. However, upper and lower respiratory tracts and urinary tract infection rates during seasonal changes were significantly different from other time of the years （P〈0.05）. Hospital infection pathogens were dominated by Gram-negative bacteria, accounted for 61.14%, and Gram-positive bacteria accounted for 15.54%. E.coli was always with the highest isolation rate. The isolation rates of Escherichia coli and Klebsiella in the third and fourth quarters of the year were significantly increased compared with those of the first and second quarters. The analysis of variation in the resistance rates of Staphylococcus aureus and Escherichia coli to some antibiotics showed significant differences. Conclusion The investigation and surveillance on the infection epidemiology of the hospital can find out the trend of nosocomial infection. It is necessary to strengthen the management and targeted surveillance focusing on the key departments, risk factors, and vulnerable populations in order to effectively reduce the occurrence of nosocomial infections.
出处
《热带医学杂志》
CAS
2014年第2期165-168,共4页
Journal of Tropical Medicine
关键词
医院感染
感染部位
病原菌
nosocomial infections
infection site
pathogenic bacteria
