摘要
目的了解医院感染现状和抗菌药物使用情况,提高医院感染防控能力。方法采用横断面调查方法对天津市某三甲医院调查日所有住院患者进行调查,对资料进行描述性分析,采用χ^2检验对样本率进行比较。结果被调查患者疾病诊断多集中于恶性肿瘤(29.82%)和循环系统疾病(17.64%)。共74例患者存在医院感染,医院感染率3.45%。是否存在手术切口、住院科室、患者疾病诊断是患者是否发生医院感染的影响因素(P<0.05)。医院感染的主要感染部位为下呼吸道感染(32.91%),感染菌株主要为肺炎克雷伯菌(15.07%)、铜绿假单胞菌(12.33%)。患者使用抗菌药物率为35.42%,475例(62.58%)患者用药前已送细菌培养。多数医院感染细菌对抗菌药物耐药率低。结论该医院医院感染率总体较低,医院感染预防控制取得了良好成效;用药规范率明显提高。建议在预防与控制医院感染时要针对重点人群和危险因素制定相应防治措施,提高医务人员合理使用抗菌药物意识,以降低细菌耐药率。
Objective To understand the status of nosocomial infection and the use of antibiotics in Tianjin,then improve the ability of infection prevention and control.Methods By means of cross-sectional survey,a unified survey was conducted for all of the patients who were hospitalized in a first-class hospital in Tianjin on the survey day.The data were compared and analyzed using Frequencies and Chi square test.Results The prevalence of diagnose were higher in cancer(29.82%)and circulatory diseases(17.64%).A total of 74 cases nosocomial infection occurred,the incidence rate of nosocomial infection was 3.45%.Incision,inpatient department and the category of disease were main risk factors of nosocomial infection(P<0.05).The patients who had lower respiratory tract infection were accounted for 32.91%.Klebsiella pneumonia(15.07%)and pseudomonas aeruginosa(12.33%)were dominant among the pathogens causing the nosocomial infections.The utilization rate of antibiotics was 35.42%.Among patients receiving antimicrobial prophylaxis,percentage of specimens sending for bacterial detection was 62.58%(475 patients).Most of the pathogens showed a good sensitivity to the antibiotics.Conclusion The results of this cross sectional survey revealed that nosocomial infection prevention and control in the first-class hospital in Tianjin has achieved remarkable results,and the standardized treatment rate is obviously increased.It is suggested that in the prevention and control of nosocomial infection,the corresponding preventive measures should be formulated according to the key population and risk factors,and the medical staff awareness of rational use of antibacterial drugs should be improved so as to reduce the rate of bacterial resistance.
作者
乔岩
魏小萌
马月
高莹
李兰
张磊
王一颖
QIAO Yan;WEI Xiaomeng;MA Yue(Tianjin Union Medicine Center,Department of Prevention and Healthcare,Tianjin,300130,China)
出处
《中国社会医学杂志》
2019年第6期638-642,共5页
Chinese Journal of Social Medicine
基金
天津市医院协会医院管理研究项目(2017003)
关键词
医院感染
三甲医院
调查研究
Nosocomial infections
First-class hospital
Survey
