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[目的]了解2005～2006年上海市普陀区各级医疗保健机构医院感染的现状,为降低院内感染率,提供科学依据。[方法]应用流行病学方法监测全区各级医疗保健机构院内感染的现状。[结果]2005～2006年院内感染率为3.89%,其中一级医院院内感染发病率为5.01%;二级医院院内感染率为4.12%;三级医院院内感染率为3.04%。院内感染率一级医院明显高于二、三级医院;二级医院高于三级医院。三者之间感染发病率的差异有统计学意义(χ2=130.75,P﹤0.001)。院内感染率无明显季节性。感染的高发科室,二级医院以ICU、干部科、CCU为主;三级医院以神经ICU、ICU、血液科为主。感染部位,二级医院以下呼吸道、泌尿道、消化道为前三位;三级医院以下呼吸道、泌尿道、上呼吸道为前3位。[结论]普陀区各级医疗保健机构院内感染率低于国内平均水平,严格消毒隔离制度、消毒技术操作规范及合理使用抗菌素是控制降低院内感染最有效手段。
[Objective] To understand the status of nosocomial infection in health care institutions at all levels in Putuo District of Shanghai from 2005 to 2006, and to provide scientific evidence for reducing the nosocomial infection rate. [Methods] Epidemiological methods were used to monitor the status of nosocomial infections in healthcare institutions at all levels in the district. [Results] The infection rate in hospital from 2005 to 2006 was 3.89%, among which the incidence of nosocomial infection in primary hospital was 5.01%. The nosocomial infection rate in secondary hospital was 4.12%. The nosocomial infection rate in tertiary hospital was 3.04%. Hospital infection rate of a hospital was significantly higher than two, three hospitals; two hospitals higher than the tertiary hospital. The incidence of infection among the three was statistically significant (χ2 = 130.75, P <0.001). No significant seasonal nosocomial infection rate. High incidence of infection departments, two hospitals to ICU, cadres, CCU-based; tertiary hospital to nerve ICU, ICU, Department of Hematology. Infection sites, the following secondary hospital respiratory tract, urinary tract, digestive tract for the top three; tertiary hospital following respiratory tract, urinary tract, upper respiratory tract for the first three. [Conclusion] The nosocomial infection rate of health care institutions at all levels in Putuo district is lower than the national average level. The strict disinfection and isolation system, the operation standard of disinfection technique and rational use of antibiotics are the most effective measures to control the nosocomial infection.