协和医学杂志

2016, (04)

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2012—2016年医院感染现患率调查
Survey on Prevalence of Hospital-acquired Infection from 2012 to 2016

孙芳艳;张国杰;郭勤;张占杰;王爱;徐英春;秦明伟

摘要(Abstract):

目的 了解医院感染的实际情况及变化趋势,以有效预防与控制医院感染。方法 采用横断面调查方法,调查北京协和医院2012 年12 月12 日、2013 年12月4日、2014年5月21日、2015年5月20日、2016年5月11日所有住院患者,对5年医院感染相关资料进行统计分析。结果 5年医院感染现患率分别为6.67%、6.33%、5.66%、5.16%、4.65%,呈逐年下降趋势。重症监护病房医院感染现患率最高。感染部位以下呼吸道感染居首位,占40.88%;其次分别为泌尿系统感染(10.81%)和手术部位感染(9.97%)。医院感染病原体以革兰阴性菌为主,占63.16%;多重耐药菌株占检出病原菌的32.85%。结论 医院感染现患率逐年下降,体现医院感染管理与控制效果显著,各科室和感染部位情况提示重症监护病房、下呼吸道感染仍是医院感染控制的重点。医院感染近年来面临多重耐药菌的威胁,在有力规范抗菌药物合理应用的同时,应加强多重耐药菌定植和感染患者的接触隔离。
Objective To investigate the prevalence of hospital-acquired infection (HAI) in a hospital and its change over time, so as to better prevent and control HAI. Methods A cross-sectional survey on prevalence of HAI was carried out among all hospitalized patients in Peking Union Medical College Hospital on December 12, 2012, December 4, 2013, May 21, 2014, May 20, 2015, and May 11, 2016, respectively. The data related to HAI in these five years were analyzed. Results The prevalence rate of HAI in the five years from 2012 to 2016 was 6.67%, 6.33%, 5.66%, 5.16%, and 4.65%, respectively, appearing to be reducing over time. The intensive care unit(ICU) had the highest infection prevalence. The top infection site was lower respiratory tract, accounting for 40.88% of all the HAI; followed by urinary tract(10.81%) and surgical site(9.97%). Gram-negative bacteria were the main pathogens of HAI, accounting for 63.16%. Multidrug-resistant organisms (MDROs) accounted for 32.85% of the total detected bacteria. Conclusions The prevalence of HAI appears to be decreasing year by year, suggesting the effect of hospital infection management and control. ICU and lower respiratory tract infection are still the focus of HAI control. HAI control is currently faced with the threat of MDROs. Contact isolation for patients with MDROs infection is equally important as rational use of antimicrobial drugs.

关键词(KeyWords): |医院感染|现患率|感染部位|多重耐药菌|
|hospital-acquired infection|prevalence|infection site|multidrug-resistant organisms|

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作者(Author): 孙芳艳;张国杰;郭勤;张占杰;王爱;徐英春;秦明伟

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