Investigation and analysis on current incidence rate of infectious diseases in a hospital
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摘要: 目的: 了解某院医院感染现患情况及抗菌药物使用情况,为修订医院感染防控措施提供循证依据。方法: 采用横断面研究、床旁调查和运行病历调查相结合的方法,调查2016年10月11日00:00~24:00所有住院患者的医院感染、标本送检及抗菌药物使用情况。结果: 共调查住院患者1 262例,发生医院感染22例、25例次,医院感染现患率为1.74%,例次现患率为1.98%。医院感染现患率最高的科室为小儿神经内科(11.54%),其次为新生儿重症监护室(NICU)7.14%。医院感染部位以下呼吸道(60.00%)为主,其次是胃肠道(12.00%)和血液(12.00%)。22例医院感染病例中共有17例标本送检,送检率为77.27%;共检出病原体7株,其中鲍曼不动杆菌和屎肠球菌各2株,近平滑假丝酵母菌、鹑鸡肠球菌、轮状病毒各1株。全院抗菌药物使用率为56.58%,治疗及治疗+预防用药标本送检率为74.23%。结论: 应加强重点科室、重点人群、重点部位的监测,合理使用抗菌药物,采取集束化干预的方法以控制或减少耐药菌的发生。Abstract: Objective: To investigate the current situation of healthcare-associated infection (HAI) in a hospital,and to know the application situation of antimicrobial agents,so as to provide scientific evidences for controlling nosocomial infection in a maternal and child healthcare hospital.Method: A cross-sectional survey was conducted by combination of bedside examination and medical record review.HAI prevalence,pathogen examination and antimicrobial agents application of all hospitalized patients from 00:00~24:00 on October 11,2016 were investigated Result: A total of 1262 hospitalized patients were investigated,22 patients developed 25 times of HAI.HAI prevalence rate and case rate was 1.74% and 1.98% respectively.The pediatric neurology had the highest prevalence rates (11.54%),followed by neonatal intensive care unit (NICU)(7.14%).Lower respiratory tract was the main site of HAI (60%),followed by gastrointestinal tract (12%) and bloodstream (12%).17 infective inpatients of 22 delivered samples for pathogenic detection,and the inspection rate was 77.27%.A total of 7 pathogenic bacteria were isolated,and the number of Acinetobacter baumannii,Enterococcus faecium,Candida parapsilosis,Enterococcus gallinarum and Rotavirus was 2,2,1,1,1 respectively.The usage rate of antimicrobial agents in hospital was 56.58%.The specimens rate of treatment and treatment+prophylaxis were 74.23%.Conclusion: Monitoring on key departments and key sites of HAI should be strengthen,and antimicrobial agents should be used rationally.The current situation of MDRO infection should be controlled and reduced through bundle intervention.
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