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目的 了解我院医院感染 (NI)现况 .方法 抽检 5 0 3例住院患者病历作现况调查 ,调查项目有年龄、性别、住院天数、NI率、NI分布、感染部位、ICU因素、侵入性诊疗操作、免疫抑制剂、广谱抗生素、化疗、放疗、输血或血制品、恶性肿瘤、慢性病、肝硬化、糖尿病、血液病、尿毒症、昏迷、老年人、新生儿、一次性医疗用品、手术伤口类型、病原学检查 .结果 NI率为 8 75 % ,其中下呼吸道感染 38 6 4%、胃肠道感染 2 2 73%、上呼吸道感染 1 3 6 4% ,泌尿道感染、真菌感染和术后感染均为 6 82 % .培养出病原菌主要为铜绿假单胞菌 2 3 5 3%、真菌、肺炎克雷伯菌均为 1 7 6 5 % ,大肠杆菌 1 1 76 % .调查前被认为的相关危险因素和易感因素经Logistic回归分析有显著性意义 (p <0 0 5 ) .结论 我院NI率低于全国平均水平 ,NI主要是下呼吸道感染 ,其发生主体是中枢神经系统疾病患者 ,神经内外科病房应该作为NI监控的重点 ,应针对较多见的铜绿假单胞菌加强预防及应对措施 .应严格限制侵入性诊疗操作 ,合理应用抗生素和免疫抑制剂 ,尽量减少血液制品的输注 ,加强对慢性病、肿瘤、老年人和新生儿护理等 .
Objective To understand the status of nosocomial infection (NI) in our hospital.Methods A total of 533 hospitalized patients were enrolled in this study, including age, gender, length of hospital stay, NI rate, NI distribution, infection site, ICU factors, invasiveness Medical Practice, Immunosuppressants, Broad Spectrum Antibiotics, Chemotherapy, Radiotherapy, Transfusions or Blood Products, Malignancies, Chronic Diseases, Cirrhosis, Diabetes, Hematology, Uremia, Coma, Elderly, Neonates, Disposable Medical Supplies, Surgical Wound type and etiological examination.Results The NI rate was 8 75%, among which 38 6 4% were lower respiratory tract infection, 22 73% gastrointestinal tract infection, 136.4% upper respiratory tract infection, urinary tract infection, fungal infection and surgery The infection rate was 6 82% .The pathogenic bacteria were mainly Pseudomonas aeruginosa 23.3%, fungi and Klebsiella pneumoniae 17.65%, Escherichia coli 11.7% (P <0.05) .Conclusion The NI rate in our hospital is lower than the national average level, NI is mainly lower respiratory tract infection, and its main occurrence is central nervous system diseases Patients, neurosurgery ward should be the focus of NI monitoring, prevention and response should be strengthened for the more common Pseudomonas aeruginosa should strictly limit the invasive diagnosis and treatment operations, the rational use of antibiotics and immunosuppressive agents, to minimize blood products Of the infusion, to strengthen the chronic diseases, cancer, the elderly and neonatal care and so on.