【摘要】 目的描述武汉地区医院感染现状,通过分析横断面调查结果的变化趋势,为制定该地区医院感染防治措施提供依据。方法采用横断面调查方法对武汉地区2010年、2012年、2014年某调查日医疗机构所有住院患者进行统一调查,对调查结果进行比较分析。结果 2010年、2012年、2014年医院感染率分别为3.53%、3.00%、3.08%,差异有统计学意义(P=0.017)且呈下降趋势;床位数<300的医疗机构医院感染率最低,三年分别为2.13%、0.27%、0.00%,随着床位数增多,现患率呈增高趋势;<300张、300～600张床位的医疗机构感染率不同年份两两比较差异有统计学意义,随年份增加呈降低趋势(P<0.05);现患率最高的科室为综合ICU(39.51%、26.29%、32.88%),其次为血液科、神经外科等;感染发生部位以下呼吸道感染为主,占49.46%;医院感染菌株主要以铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌为主;2010年、2012年、2014年三次调查平均抗菌药物使用率分别为51.39%、39.87%、39.94%,差异有统计学意义(χ~2=853.399,P=0.017);同一年份不同规模机构的抗菌药物使用率呈下降趋势(趋势性χ~2=587.781,P<0.001)。结论医院感染横断面调查可基本反映目前武汉地区医院感染管理存在的问题,明确了今后医院感染相关控制措施的实施重点。更多还原

【Abstract】 OBJECTIVE To investigate the prevalence of nosocomial infections in Wuhan area and analyze the result of the cross-sectional survey so as to provide guidance for prevention and treatment of the nosocomial infections in this area.METHODS By means of cross-sectional survey,a unified survey was conducted for all of the patients who were hospitalized in medical institutions of Wuhan on a day of 2010,2012 and 2014,and the result of the survey was observed and compared.RESULTS The incidence rate of nosocomial infections was 3.53%in 2010,3.00%in2012,3.08%in 2014,there was significant difference(P=0.017),and the incidence rate of nosocomial infections showed a downward trend.The incidence rate of nosocomial infections was the lowest in the medical institutions with the number of beds less than 300,2.13%in 2010,0.27%in 2012,0.00%in 2014.The prevalence rate of nosocomial infections was increased with the increase of the number of beds.There was significant difference in the incidence rate of nosocomial infections between the medical institutions with less than 300 beds and those with 300-600 beds,and the incidence rate of nosocomial infection showed a downward trend with the years(P<0.05).The prevalence rate of nosocomial infections was the highest in comprehensive ICU(39.51%,26.29%,32.88%),followed by hematology department and neurosurgery department.The patients who had lower respiratory tract infection accounted for 49.46%.Pseudomonas aeruginosa,Escherichia coli and Acinetobacter baumannii weredominant among the pathogens causing the nosocomial infections.The average utilization rate of antibiotics was51.39%in 2010,39.87% in 2012,39.94% in 2014,and there was significant difference(χ~2=853.399,P=0.017).The utilization rate of antibiotics showed a downward trend in the different scale of medical institutions in the same year(trend χ~2=587.781,P<0.001).CONCLUSIONThe cross-sectional survey of the nosocomial infection may basically reflect the problems in control of nosocomial infections in Wuhan,which facilitates the understanding of focal points of implementation of the related control measures.更多还原