巴楚医学

目的:了解全市医院感染的发病现状。方法:采用现患率调查方法,对全市二级及以上医疗机构医院感染现患率进行调查,包括医院感染患病情况、抗菌药物使用情况和病原学送检情况。结果:本研究调查了35家医院,共17 441例住院患者,发现医院感染患者328人,医院感染现患率1.88%。医院感染主要发生于重症监护病房(19.49%),其次为神经外科(9.19%)、血液科(5.91%)、消化科(5.44%)、烧伤科(4.88%)以及新生儿病房(3.57%)。医院感染发生部位以下呼吸道(49.56%)为主,其次为泌尿道(13.41%)、上呼吸道(9.91%)、手术部位(9.91%)以及胃肠道(6.71%)。医院感染的病原体主要为革兰阴性杆菌(80.32%),其耐药菌发生较少;尽管革兰阳性球菌的发生率较低(14.96%),但耐药菌发生情况较多。抗菌药物的使用率为29.95%,主要以治疗性使用为主,且抗菌药物单独使用为主(87.19%)。其中,治疗性使用抗菌药物患者的病原体送检率为56.29%,规模较大的医院送检率较高。结论:本地医院感染主要发生在重症监护病房,以下呼吸道感染为主,病原体主要为革兰阴性杆菌,但应注意革兰阳性菌出现耐药菌情况。住院患者的抗菌药物使用率为29.95%,联用抗菌药物比例不高。

Objective:To understand the prevalence rate of nosocomial infection in the whole city.Methods:The survey method was used to investigate the prevalence rate of nosocomial infection in the second-level and above medical institutions,including the prevalence of nosocomial infection,the use of antimicrobial drugs,and the status of pathogenic examinations.Results:There were 35 hospitals including 17 441 inpatients investigated.It was found that there were 328 patients with nosocomial infection,with the prevalence rate of1.88%.Nosocomial infection mainly occurred in the intensive care unit(19.49%),followed by neurosurgery(9.19%),hematology(5.91%),gastroenterology(5.44%),burns department(4.88%)and neonatal ward(3.57%).The site of nosocomial infection was mainly in lower respiratory tract(49.56%),followed by urinary tract(13.41%),upper respiratory tract(9.91%),surgical site(9.91%),and gastrointestinal tract(6.71%).The pathogen of hospital infection was mainly Gram-negative bacilli(80.32%),which had less drug-resistant bacteria.Although the incidence of Gram-positive cocci was low(14.96%),the occurrence of drug-resistant bacteria was more frequency.The usage of antibacterial drugs was 29.95%,mainly for therapy,and used alone(87.19%).Among them,the pathogen detection rate of patients with antibacterial drugs therapy was 56.29%,which was higher in large-scale hospitals.Conclusion:The local nosocomial infection often occurred in the intensive care unit,which was mainly performed in lower respiratory tract.Although the pathogens are mainly Gram-negative bacilli,the resistance of Gram-positive bacteria should be paid more attention to.The utilization rate of antibacterial drugs in hospitalized patients was 29.95%,with low proportion of combined antibiotics.