摘要
目的了解赣州市二级及以上公立医院医院感染的现状特征及其感染影响因素,为预防与控制医院感染提供科学依据。方法采用床旁调查与病历调查相结合的横断面调查方法,对赣南地区35所二级以上公立医院2018年3月1日-11月15日自行选择某日00:00-24:00所有住院患者进行医院感染现患率调查,分析其患者并发感染的部位、病原体检出及抗菌药物使用情况等,对引起感染的影响因素进行单因素和多因素Logistic回归分析。结果共调查15 329份住院病例,医院感染现患率为2.41%,例次现患率为2.47%。医院感染部位以下呼吸道为主,占52.51%,其次是泌尿道、表浅切口、皮肤软组织、上呼吸道等;医院感染常见病原菌以革兰阴性菌为主,占74.87%,革兰阳性菌及真菌分别占18.72%、6.42%,主要为铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌;调查当日抗菌药物使用率为39.71%;Logistic回归模型显示,住院天数(≥20 d)、外科手术、抗菌药物联用、中心静脉置管、泌尿道插管及使用呼吸机均是发生医院感染的影响因素,差异有统计学意义(P<0.05)。结论医院感染现患率调查有助于进一步了解赣南地区公立医院感染发生现状,各医院应给予高度重视,加强医院感染监测,尽量缩短平均住院日、减少不必要的侵入性操作、合理使用抗菌药物等,制定综合有效的感染防控措施,以降低医院感染发生率。
OBJECTIVE To understand the characteristics and risk factors of nosocomial infection in above secondary public hospitals in south of Jiangxi, and to provide scientific basis for the prevention and control of nosocomial infection. METHODS By using the cross-sectional survey method of bedside survey and medical record survey, the incidence of nosocomial infection was investigated in 35 public hospitals above the second level in Gannan from March 1 to November 15, 2018. The location of concurrent infection, the detection rate of pathogens and the antibiotics usage were analyzed. Relevant factors of infection were analyzed by single factor and multi factor Logistic regression analysis. RESULTS A total of 15329 hospitalized cases were enrolled. The prevalence rate of nosocomial infection was 2.41% and that of cases was 2.47%. The main nosocomial infection sites were lower respiratory tract(52.51%), followed by urinary tract, superficial incision, skin and soft tissue and upper respiratory tract. The common pathogens of nosocomial infection were Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii;the utilization rate of antibiotics was 39.71% on the day of investigation;logistic regression model showed that hospitalization days(>20 days), surgery, antibiotics combination, central venous catheterization, urinary catheterization and ventilator usage were all independent risk factors for nosocomial infection, and the difference was significant(P<0.05). CONCLUSION Investigation of the nosocomial infection prevalence rate is helpful to further understand the current situation of public nosocomial infection in the south of Jiangxi. Hospitals should attach great importance to strengthening nosocomial infection surveillance, shortening average hospitalization days, reducing unnecessary invasive operations, rational use of antibiotics and so on. Comprehensive and effective infection prevention and control measures should be performed to reduce the incidence of nosocomial infection.
作者
罗锋
冯秋女
黄楚菁
陈锦峰
陈继安
蔡春梅
胡涛
熊自超
LUO Feng;FENG Qiu-nv;HUANG Chu-jing;CHEN Jin-feng;CHEN Ji-an;CAI Chun-mei;HU Tao;XIONG Zi-chao(People's Hospital of Ganzhou City,Ganzhou,Jiangxi 341000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第24期3790-3794,共5页
Chinese Journal of Nosocomiology
