贵州省布依族自治州医院感染现患率与抗菌药物使用情况调查

摘要

目的：了解贵州省布依族自治州医院感染现状，为医院感染防控措施的制定提供依据。方法采用床旁调查和病历调查相结合的方法，2014年9月10日—10月5日对贵州省布依族地区二级及二级以上医院进行医院感染现患率调查。结果应调查住院病例6577例，实际调查6541例，实查率99．45％。其中医院感染120例、127例次，医院感染现患率为1．83％，例次现患率为1．94％。医院感染居前3位的科室依次为综合重症监护病房（26．32％）、神经外科（6．10％）、儿科新生儿组5．13％；感染部位以下呼吸道居首位（39例次，30．71％），其次为皮肤软组织（24例次，18．90％），表浅切口（23例次，18．11％）。共检出病原体58株，以革兰阴性菌为主（44株），革兰阳性菌10株，真菌3株。调查日抗菌药物使用率为42．12％，其中治疗用药占64．75％，预防用药占26．83％，预防＋治疗用药占8．42％；单一用药占79．53％，二联用药占19．89％，三联及以上用药占0．58％；治疗用药及治疗＋预防用药患者细菌培养送检率为13．76％。结论医院感染现患率调查有助于了解医院感染现况，建议加强医院重点科室重点部位医院感染监测，有效降低医院感染的发生。%Objective To explore the status of healthcare-associated infection(HAI)in hospitals in Buyi autono-mous prefecture of Guizhou Povince,and provide basis for formulating HAI control measures.Methods A survey was conducted by combined methods of bed-side survey and medical record reviewing,prevalence rates of secondary and above hospitals in Buyi autonomous prefecture in Guizhou Province between September 10 and October 5,2014 were surveyed.Results 6 577 hospitalized patients should be investigated,6 541(99.45%)were actually investiga-ted.The prevalence rate and case prevalence rate of HAI were 1 .83% (n=120)and 1 .94%(n=127)respectively. The top three departments of HAI distribution were intensive care unit (26.32%),neurosurgery (6.10%),and neonatal intensive care unit(5.13%);the main infection site was lower respiratory tract(n=39,30.71 %),followed by skin-soft tissue (n=24,18.90%)and superficial incision (n=23,18.11 %).58 pathogenic isolates were detec-ted,gram-negative bacteria were the major pathogens (n=44),gram-positive bacteria and fungi were 10 and 3 iso-lates respectively.Antimicrobial usage rate at survey day was 42.12%,64.75% of which were for therapeutic, 26.83% for prophylactic,and 8.42% for therapeutic+prophylactic use;the percentage of mono-drug,two drugs combination,and three or more drugs combination use were 79.53%,19.89%,and 0.58% respectively;bacterial detection rate in patients receiving therapeutic as well as therapeutic+prophylactic antimicrobial use was 13.76%. Conclusion Survey on prevalence of HAI is helpful for understanding the current status of HAI,monitoring on HAI in key departments of hospital and key sites of patients should be strengthened to reduce the occurrence HAI effectively.