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目的了解贵州省医院感染现状,为进一步预防和控制医院感染提供科学依据。方法 2014年9月5-30日,贵州省174所二级及二级以上医院参与医院感染现患率调查。参与调查的各医院自行确定调查日,采取床旁调查和查阅住院病历相结合的方法,对参与调查医院调查日(0:00-24:00)的所有住院患者进行调查。结果医院感染横断面调查实查率99.66%(65 885/66 111),发生医院感染1 546例,1 643例次,医院感染现患率为2.35%(1 546/65 885),例次现患率为2.49%(1 643/65 885)。不同规模医院医院感染现患率比较,差异有统计学意义(χ2=56.35,P<0.01);重症医学科(25.20%)为医院感染高发科室;感染部位以下呼吸道(40.35%)为主;革兰阴性菌(70.37%)位居医院感染病原菌首位,不同科室、感染部位、病原菌的医院感染现患率比较,差异均有统计学意义(χ2=1 209.54,P<0.01,χ2=1 041.43,P<0.01,χ2=1167.40,P<0.01);调查当日抗菌药物使用率为39.24%(25 851/65 885),治疗用药为主占67.24%(17 382/25 851);治疗使用抗菌药物者病原菌培养送检率为32.81%(25 851/65 885)。结论重点监控ICU,呼吸道感染和革兰氏阴性杆菌,合理使用抗菌药物,提高病原菌送检率从而降低医院感染风险。
Objective To understand the status of nosocomial infection in Guizhou Province and provide scientific evidence for further prevention and control of nosocomial infections. Methods From September 5 to September 30, 2014, 174 prevalence rates of nosocomial infections in 174 secondary and secondary hospitals in Guizhou province were investigated. All the hospitals participating in the investigation determined the survey day by themselves and adopted the combination of bedside investigation and inpatient medical records to investigate all inpatients participating in the survey on the hospital (0: 00-24: 00). Results The investigation rate of cross-sectional nosocomial infection was 99.66% (65 885/66 111), 1 546 nosocomial infections and 1 643 nosocomial infections were found. The prevalence of nosocomial infections was 2.35% (1 546/65 885) 2.49% (1 643/65 885). The incidence rates of nosocomial infections in hospitals of different scales were statistically significant (χ2 = 56.35, P <0.01). The incidence of nosocomial infections in intensive-care departments was 25.20% Negative bacteria (70.37%) ranked the first among the nosocomial infection pathogens. The prevalence of nosocomial infections among different departments, infected sites and pathogens was statistically significant (χ2 = 1 209.54, P <0.01, χ2 = 10441.4, P < 0.01, χ2 = 1167.40, P <0.01). The antimicrobial use rate was 39.24% (25 851/65 885) on the day of investigation, and 67.24% (17 382/25 851) The rate was 32.81% (25 851/65 885). Conclusions The ICU, respiratory tract infection and Gram-negative bacilli are mainly monitored, antibacterials are used reasonably, and the rate of pathogenic bacteria is increased so as to reduce the risk of nosocomial infection.