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目的了解医院感染现状,为采取针对性的医院感染管理措施提供依据。方法采用横断面调查的方法,采用病历调查与床旁调查相结合的模式,对2011年6月25日住院患者进行医院感染调查。结果共调查1035例患者,医院感染率为5.31%;感染率较高的科室为ICU 30.00%、儿科19.15%、新生儿室14.29%和神经外科11.36%;下呼吸道为主要感染部位,占49.23%;呼吸机相关性肺部感染率为34.12%,中心静脉导管相关性血流感染率为2.38%,泌尿道插管相关性泌尿道感染率为1.59%;病原学培养送检率为45.45%,主要病原菌为鲍氏不动杆菌和铜绿假单胞菌;调查当日抗菌药物使用率46.18%;治疗用药物送细菌培养率27.76%;使用频度前10位的抗菌药物30.00%为医院常规药敏试验品种,50.00%为作用、性质近似品。结论医院感染日常监测中部分科室存在漏报现象;ICU、儿科、新生儿室为医院感染重点监测部门;应采取综合措施降低呼吸机、中心静脉置管、泌尿道置管等侵入性操作所致医院感染;医院常规药敏试验品种应根据临床药物使用情况及时调整,应加强医院感染病例和治疗用药的细菌学检查。
Objective To understand the current situation of nosocomial infection and provide the basis for taking targeted hospital infection management measures. Methods The method of cross-sectional survey was used to investigate the nosocomial infection in hospitalized patients on June 25, 2011 using the combination of medical records and bedside surveys. Results A total of 1035 patients were investigated, and the hospital infection rate was 5.31%. The highest infection rate was 30.00% in ICU, 19.15% in pediatrics, 14.29% in neonates and 11.36% in neurosurgery. The lower respiratory tract was the main infection site accounting for 49.23% ; Ventilator-associated lung infection rate was 34.12%, central venous catheter-related bloodstream infection rate was 2.38%, urinary tract intubation-related urinary tract infection rate was 1.59%; etiological culture delivery rate was 45.45% The main pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa; the antimicrobial use rate was 46.18% on the day of investigation; the rate of 27.86% of the bacteria used in the treatment was sent to the hospital; the antimicrobial drug 30.00% Test varieties, 50.00% for the role of similar nature of goods. Conclusion There are some omissions in some departments of routine monitoring of nosocomial infections. ICU, pediatrics and neonatal units are the key monitoring departments of nosocomial infection. Comprehensive measures should be taken to reduce invasive procedures such as ventilator, central venous catheterization and urinary catheterization. Hospital infection; hospital routine drug susceptibility testing varieties should be based on the timely adjustment of clinical drug use, should strengthen the hospital infection cases and treatment of bacteriological examination.