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目的探讨综合性医院的医院感染和病原菌分布情况,为预防与控制医院感染提供科学依据。方法对2010-2012年出院的患者医院感染情况进行回顾性调查分析。结果发生医院感染4 007例,感染率为2.69%,感染例次4 430,感染例次率2.97%。医院感染率居首位的科室为ICU病房,侵袭性操作如泌尿道插管、呼吸机等是医院感染的重要因素。本调查显示4个季度医院感染在例数上无明显差异,但主要易感部位上呼吸道、下呼吸道、泌尿道的季节变化差异有统计学意义(P<0.05),医院感染病原菌以革兰阴性菌为主,占61.14%,革兰阳性菌占15.54%,大肠埃希菌的分离率最高。大肠埃希菌、克雷伯菌的分离率在三、四季度较一、二季度有明显升高。对临床上最常见金黄色葡萄球菌与大肠埃希菌的耐药率变化分析显示,部分抗生素的总体耐药率变化差异有统计学意义。结论通过对医院感染的流行病学调查和监测,可以发现医院感染变化的趋势及医院感染控制的关键点,针对重点科室、危险因素、易感人群加强管理和目标监测,可有效降低医院感染的发生。
Objective To explore the distribution of nosocomial infections and pathogens in general hospitals and to provide a scientific basis for the prevention and control of nosocomial infections. Methods Retrospective analysis of nosocomial infections in patients discharged from 2010 to 2012 was conducted. Results 4 007 cases of hospital infection occurred, the infection rate was 2.69%, the infection rate was 4 430 and the infection rate was 2.97%. Hospitals ranked first in the hospital for the ICU ward, invasive operations such as urinary catheterization, ventilator and other hospital infection is an important factor. The survey showed no significant difference in the number of nosocomial infections among the four quarters, but there were significant differences in the seasonal changes of the upper respiratory tract, lower respiratory tract and urinary tract in the predominant susceptible sites (P <0.05). The nosocomial pathogenic bacteria were gram negative Accounting for 61.14%, Gram-positive bacteria accounted for 15.54%, the highest isolation rate of Escherichia coli. Escherichia coli, Klebsiella separation rate in the third and fourth quarters than the first and second quarter increased significantly. Analysis of the change of drug resistance rate of the most common Staphylococcus aureus and Escherichia coli in clinics showed that there was a significant difference in the overall drug resistance rate of some antibiotics. Conclusion Through the epidemiological investigation and monitoring of nosocomial infections, the trend of nosocomial infections and the key points of nosocomial infection can be found out. For the key departments and departments, the risk factors and the susceptible population strengthen management and target monitoring, which can effectively reduce the nosocomial infection occur.