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目的了解医院住院患者医院感染的现状,掌握抗菌药物使用情况,提出相关问题并实施改进措施。方法采用病历查询和床旁调查的方式,填写床旁调查表和个案登记表,医院感染专职人员进行审核、汇总和统计分析。结果医院感染现患率为4.72%,感染部位主要为呼吸道(46.32%)和泌尿道(17.89%)。现患率最高科室为综合ICU(44.44%),其次是急诊ICU(28.57%)、烧伤科(18.75%)。抗菌药物使用率为37.37%,其中治疗用药和预防用药分别占52.82%和34.40%。抗菌药物使用以一联和二联用药为主,占75.80%和21.16%。治疗用药中病原学送检率为55.92%。病原学检测中以革兰阴性杆菌为主,占56.10%;革兰阳性球菌占30.49%;其中多重耐药菌占15.85%。结论加强对重点科室医院感染的管理和监控,提高全院职工医院感染意识,进一步加强抗菌药物的合理使用。
Objective To understand the current status of nosocomial hospital patients with nosocomial infections, to understand the use of antimicrobial agents, to propose related problems and to implement improvement measures. Methods Using the way of medical record inquiry and bedside investigation, fill in the bedside questionnaire and case registration form, and examine and summarize and statistically analyze the full-time hospital infection personnel. Results The prevalence rate of nosocomial infection was 4.72%. The main infection sites were respiratory tract (46.32%) and urinary tract (17.89%). The prevalence of the highest department for the integrated ICU (44.44%), followed by emergency ICU (28.57%), burns (18.75%). Antibiotics use rate was 37.37%, of which 52.82% and 34.40% were used for treatment and prophylaxis respectively. Antimicrobials were mainly used in combination with two drugs, accounting for 75.80% and 21.16% respectively. The rate of etiology in treatment was 55.92%. Gram-negative bacilli were the main pathogens, accounting for 56.10%; Gram-positive cocci accounted for 30.49%; and multi-drug resistant bacteria accounted for 15.85%. Conclusion The management and monitoring of nosocomial infections in key departments and departments should be strengthened to raise awareness of hospital infection among staff and workers in hospital and to further enhance the rational use of antimicrobial agents.