2014年贵州省医疗机构住院患者医院感染和社区感染现患率调查

摘要

目的 了解贵州省医疗机构住院患者医院感染与社区感染现状,以及抗菌药物使用情况.方法 2014年9月对贵州省174所二级及二级以上医疗机构住院患者感染情况进行横断面调查.结果 共调查68 419例住院患者,实查率为99.65％.发生医院感染1 581例、1 684例次,医院感染现患率为2.31％、例次现患率为2.46％,发生社区感染18 571例、19 191例次,社区感染现患率为27.14％、例次现患率为28.05％;医院感染和社区感染现患率最高的科室分别为综合ICU、儿科非新生儿组.医院感染部位和社区感染部位比较差异有统计学意义(x2 =17 325.44,P＜0.01);医院感染和社区感染的病原菌均以大肠埃希菌为主.调查日抗菌药物使用率为39.82％,使用率最高的为综合ICU(80.47％)和儿科(76.67％).用药目的以治疗用药为主[18 386例(67.48％)],联合用药以单一用药为主[21 672例(79.55％)].治疗使用抗菌药物者病原菌培养送检率为31.76％.结论 此次调查有助于了解贵州省医院感染和社区感染高发科室、高发部位,以及治疗使用抗菌药物患者病原学送检情况,为进一步的预防与控制医院感染提供依据.%Objective To investigate the current status of healthcare-associated infection (HAI),community-associated infection(CAD,and antimierobial use in hospitalized patients in medical institutions of Guizhou Province.Methods In September 2014,infection status of hospitalized patients in 174 second level hospitals and above in Guizhou Province were performed cross-sectional survey.Results A total of 68 419 patients were surveyed,the actual survey rate was 99.65％.1 581 patients developed 1 684 cases of HAI,HAI prevalence rate and HAI case prevalence rate were 2.31％ and 2.46％ respectively,18 571 patients developed 19 191 cases of HAI,CAI prevalence rate and CAI case prevalence rate were 27.14％ and 28.05％ respectively;patients in general intensive care unit(ICU) and pediatric department(non-neonatal group) had the highest HAI and CAI prevalence rates respectively.Constituent ratios of HAI and CAI sites was significantly different(x2 =17 325.44,P＜0.01);Escherichia coli was the main pathogen causing HAI and CAI.Utilization rate of antimicrobial agents on the survey day was 39.82 ％,ICU (80.47 ％) and pediatric department (76.67 ％) were the highest.Therapeutic antimicrobial use accounted for 67.48 ％ (n =18 386),single antimicrobial use accounted for 79.55 ％ (n =21 672).Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 31.76％.Conclusion This survey is helpful for understanding the high risk departments and sites of HAI and CAI in Guizhou Province,as well as pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents,which provides basis for further prevention and control of HAI.