2012-2014年上海市浦东新区医院感染暴发事件的监测和处置

摘要

Objective To establish emergency disposal procedures of healthcare-associated infection(HAI) in Pudong New Area, evaluate on-site investigation method, identify the key links and risk factors for infection, and timely control HAI outbreak.Methods From January 2012 to December 2014, epidemiological investigation on HAI outbreaks in 65 hospitals in Pudong New Area was performed, emergency plan for disposal procedures of HAI was initiated, the emergency disposal procedures of each event was evaluated by experts.Results There were 6 infection outbreaks occurred in Pudong New Area from January 2012 to December 2014, all were HAI, and no community-associated infection existed simultaneously;6 cases of HAI outbreaks involved 119 persons, the major were hospitalized patients (n=99,83.19%) and care workers (n=16,13.45%);5 outbreaks all detected Norovirus, the main transmission route wasclose contact of nurses with patients during care for patients;the evaluation of each incident revealed that the total score was >90.Conclusion The emergency disposal procedure of HAI suitable for Pudong New Area has been established, the effect is good and proved effective according to the expert evaluation on practical outbreaks.%目的 建立浦东新区医院感染应急处置流程,探讨现场调查方法,明确感染关键环节和危险因素,及时控制医院感染暴发事件.方法 2012年1月-2014年12月对浦东新区65所各级医疗机构发生的医院感染暴发事件开展流行病学调查,启动浦东新区医院感染应急处置预案,并对每起事件的应急处置流程进行专家评估.结果 2012年1月-2014年12月,共监测浦东新区发生医院感染暴发事件6起,全部为医院感染,无社区感染并存;6起医院感染暴发事件共涉及人员119例,其中主要为住院患者99例(83.19%)、护工16例(13.45%)等;5起均检出诺如病毒,传播途径以护工在护理患者过程中密切接触导致病毒传播为主;每起事件评价结果显示总分均>90分.结论 初步建立了一套适用于浦东新区的医院感染应急处置流程,通过实际案例运用后经专家评估效果良好.