2013年医院住院患者院内感染调查与分析

目的了解大连大学附属新华医院各主要科室院内感染发生情况及其致病菌的分布及耐药性情况,为临床制定医院感染控制措施提供参考依据。方法对2013年该院住院患者院内感染发生情况、感染病原菌分布及耐药性情况进行回顾性分析。结果全年合计住院10 985例,发生医院感染368例,医院感染发生率为3.35%。医院感染病例中60岁占3.86%。感染部位以呼吸道为主,占73.10%;ICU病房院内感染发生率最高,占15.30%。全年检测标本10 205份,检出致病菌421株,其中多重耐药菌79株,占致病菌总数的18.76%。分离多重耐药菌主要种类依次为产ESBLs大肠埃希菌、耐甲氧西林金黄色葡萄球菌、产ESBLs肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌。结论大连大学院附属新华医院院内感染率低于国内综合性医院,病原菌耐药现状不容乐观;应加强临床抗菌药物管理和细菌耐药性监测,减少耐药菌株的产生及扩散。

Investigation and analysis on nosocomial infectiom in in-patients hospitalized in 2013

Objective To learn the incidence of nosocomial infections and distribution and drug resistance of pathogens from main departments of Xinhua Hospital, and provide basis for the control of hospital infections. Methods The incidence of nosocomial infections as well as the distribution and drug resistance of the pathogenic bacteria were retrospectively analyzed. Results Of the total 10,985 cases, 368 cases （3.35%） developed hospital acquired infections. 2.39% of the hospital infection cases were of ages younger than 7 years old, 1.71% were of 7 to 59 years old, and 3.86% were of 60 years old or older. The main infection site was respiratory tract, accounting for 73.10%. The incidence in ICU was the highest （ 15.30% ）. Among the total 10,205 specimens, 421 strains of pathogenic bacteria were found, including 79 strains of multiple resistant ones （ 18.76% ）. The main types of multi-resistant strains were ESBLs producing Escherichia coli, Methicillin resistant Staphylococcus aureus, ESBLs producing Klebsiella pneuraoniae, Baurnan acinetobacter and Pseudomonas aeruginosa. Conclusion The incidence rate of hospital infections in Xinhua Hospital is lower than the other general hospitals in China. The drug resistance of these bacteria must be monitored and the clinical management of antibiotics be strengthened in order to reduce the emergence and spread of drug-resistant strains.