目的 为贯彻落实卫生部《医院感染管理办法》、《抗菌药物合理应用指导原则》，了解成都三六三医院医院感染的现状，对医院感染控制工作进行评价，提高医务人员的感染控制意识。 方法 制定统一调查方案与措施，逐一查看2011年9月21日全院住院患者在架病历，对全院住院患者通过床旁询问和体检的方式进行调查。 结果 全院共有住院患者621例，实查621例，实查率100%。发生医院感染19例，现患率为3.06%。抗生素使用率46.38%。病原学送检率21.88%。 结论 加强医务人员医院感染知识的培训是提高其医院感染防控意识的重要手段；提高感染患者病原学送检率，减少经验性用药，依据药敏结果合理使用抗生素，达到有效减少耐药菌产生的目的。
ObjectiveTo explore the continuous changing trend of healthcare-associated infection prevalence rate in a children’s hospital.MethodsFrom July 2012 to November 2018, a cross-sectional survey was conducted to investigate the prevalence of healthcare-associated infections in hospitalized children for seven consecutive years by combining case-checking and bedside survey.ResultsA total of 10 310 hospitalized children were investigated in the past seven years. The incidence of healthcare-associated infections from 2012 to 2018 was 2.08%, 4.84%, 1.59%, 3.76%, 1.63%, 1.74%, and 2.08%, respectively, showing a statistically significant downward trend (LLA=7.631, P=0.006). The departments with higher proportion of healthcare-associated infections were pediatric surgery (50.0%), pediatric medicine (44.8%), neonatal medicine (2.8%), and intensive care units (2.4%) . Viruses (38.8%) were the most common pathogens of healthcare-associated infections, followed by Gram-negative bacteria (34.3%) .ConclusionsThe prevalence of healthcare-associated infections in the children’s hospital showed a downward trend year by year. Pediatric surgery is the most common occurrence department, and viruses are the most common pathogens. It can provide evidence for prevention and control of healthcare-associated infection in children’s hospitals.
目的 了解四川省人民医院2011年的医院感染情况及其高危因素、抗菌药物使用情况。 方法 2011年9月采用横断面调查、床旁调查和病历调查相结合的方法，调查该院在调查日的医院感染、高危因素和抗菌药物使用等信息。 结果 调查住院患者1 898例，医院感染现患率4.53%，医院感染例次率4.64%；动静脉插管、呼吸机使用、泌尿道插管、气管切开、激素使用、化学疗法和免疫抑制剂的使用、血液透析等为医院感染的高危因素；调查当日抗菌药物使用率为32.93%。 结论 通过医院感染横断面调查可方便、快捷地获得全院医院感染方面的信息，为医院感染防控工作的开展提供依据。
目的 调查四川省妇幼保健院医院感染发生情况及影响因素，以改进医院感染发病率监测方法与医院感染预防和控制措施。 方法 对2011年9月19日0：00～24：00所有住院患者进行调查，包括当日出院、转院、死亡的患者，但不包括新入院患者，使用全国医院感染监控网统一设计的调查表，采用床旁调查和查阅病历相结合，对调查结果进行统计分析。 结果 应调查住院患者112例，实际调查109例，实查率为97.3%；发生医院感染4例，现患率为3.7%。医院感染部位以呼吸道为主，抗菌药物使用率为64.2%。 结论 通过医院感染现患率调查，可以在短期内全面了解医院感染的现状，针对性的制定医院感染监控措施，预防和控制医院感染的发生。
Objective To understand the current situation of healthcare-associated infection (HAI) in comprehensive hospitals with a number of beds≥900, and provide a reference for the next step in formulating HAI prevention and control measures. Methods The data on the prevalence rate of HAI in comprehensive hospitals with a number of beds≥900 of Yunnan Province between 2020 and 2022 were retrospective collected. The HAI situation and trend in each year were analyzed. Results A total of 119 comprehensive hospitals were included, with 166 745 patients surveyed and 3 237 cases of HAI. Lower respiratory tract infection and urinary tract infection were the most common sites. The department with the highest incidence of hospital infections was the intensive care unit, followed by neurosurgery and hematology. The prevalence rates of HAI showed a downward trend from 2020 to 2022 (2.08% vs. 1.99% vs. 1.79%, χ2=14.301, P<0.001). A total of 1 315 strains of hospital-acquired pathogens were detected, all of which were mainly Gram-negative bacteria, with Escherichia coli and Klebsiella pneumoniae being more common. The rate of antibiotics use and the rate of pathogen testing showed an upward trend from 2020 to 2022 (χ2=79.233, 23.866, P<0.001), the infection rate of incision site and the prophylactic use rate of antimicrobial drugs in patients with class Ⅰ surgery both showed a decreasing trend (χ2=15.551, 6.311, P<0.05). Conclusions The prevalence of infection in comprehensive hospitals of Yunnan Province is decreasing. But the supervision of key departments, the implementation of pathogen prevention and control measures, and the rational use of antibiotics in inpatients are still the focus of future work.
ObjectiveTo investigate the prevalence rate of nosocomial infection in West China Hospital of Sichuan University and to analyze the implementation effect of nosocomial infection control measures, so as to provide reference for infection control.MethodsAn investigation of the prevalence rate of nosocomial infections was performed on patients who were admitted in West China Hospital of Sichuan University from 0:00-24:00 on a day of every late June from 2012 to 2018 by using bedside investigation in combination with inpatient medical record query, and the data was verified, summarized, and statistically analyzed by the professionals of Nosocomial Infection Management Department.ResultsFrom 2012 to 2018, the prevalence rates of nosocomial infections were 5.19%, 4.20%, 3.94%, 4.26%, 4.29%, 4.25%, and 2.97% in West China Hospital of Sichuan University, which tended to decline (χ2=32.826, P<0.001). There was no significant difference in annual total infection rate in the Department of Internal Medicine, however, the infection rate in the Department of Hematology tended to decline (χ2=6.127, P<0.05); in the Department of Surgical Medicine, the total infection rate tended to decline(χ2=18.721, P<0.001); in particular, the infection rate in the Department of Thoracic Surgery tended to decline(χ2=3.906, P<0.05); the annual difference in infection rate in the Intensive Care Unit (ICU) was not statistically significant. The key site of nosocomial infection was dominated by the lower respiratory tract, and the annual difference was not statistically significant. In particular, postoperative pneumonia has increased since 2014 (χ2=9.56, P=0.002). The nosocomial pathogens which had the highest constituent ratio over the years were Acinetobacter baumannii (in 2012, 2013, 2014, 2017, and 2018), Klebsiella pneumonia (in 2015), and Escherichia coli (in 2016). The annual difference in rate of antimicrobial use was not statistically significant(χ2=3.75, P=0.053), while the rate of antimicrobial use in the ICU tended to decline (χ2=30.42, P=0.000).ConclusionsThe prevalence rate of nosocomial infection in West China Hospital of Sichuan University tends to decline. However, sufficient attention still requires to be paid to lower respiratory tract infection, particularly for patients with postoperative pneumonia.
ObjectiveTo understand the current status of nosocomial infections in a municipal medical unit, to find problems in daily monitoring, and to provide the evidence for the prevention and control of nosocomial infection in high-risk groups and procedures. MethodsAccording to the 2013 survey requirements made by the nosocomial infection control center of Chengdu, we made a cross-sectional survey about nosocomial infection among all the inpatients on July 25th, 2013 and statistically analyzed the results. ResultsTotally, 1 301 cases were actually investigated within 1 307 inpatients of the time (the actual investigation rate was 99.54%). The prevalence rate of nosocomial infection was 3.38% (44 cases). The top five departments of infection rate were Respiratory Intensive Care Unit (RICU), Center of Intensive Care Unit (CICU), Department of Neurosurgery, Department of Thoracic Surgery and Department of General Surgery. The main site of infection was respiratory tract, which took possession of 62.25%. In univariate analyses, age≥60, length of hospital stay >2 weeks, invasive operation, history of diabetes, operation, radiotherapy/chemotherapy, utilization of antibiotics were found to be risk factors for infections. Multivariate analysis showed that length of hospital stay (OR=3.115, P=0.001), invasive operation (OR=14.930, P<0.001), diabetes mellitus (OR=2.157, P=0.046), radiotherapy/chemotherapy (OR=7.497, P<0.001) were independent risk factors for nosocomial infections. The utilization rate of antibiotics was 45.73%. Among them, there was 85.21% using single antibiotics, and 82.18% of them were used therapeutically. ConclusionUnderstanding the current status of nosocomial infection in municipal hospitals helps us grasp the key and difficulty of infection control, make out prevention-control measures for high-risk groups and high-risk departments, and guide and supervise its implementation in clinical departments, which points out the direction to further reduce the incidence of nosocomial infection.
目的 探讨加强抗菌药物合理应用管理后医院感染发生及分布的变化趋势，为实现循证管理提供科学依据。 方法 对2010年8月－2012年6月医院感染现患率调查结果进行比较分析。 结果 2012年医院感染现患率为1.78%，与2010年的3.61%相比较，差异有统计学意义（P＜0.05）。手术切口感染构成比由30.0%降为0.0%。抗菌药物使用率，由2010年的50.18%降至29.08%降低明显；2012年抗菌药物单联使用率为89.80%，较2010年71.22%明显提升，且无三联用药病例。 结论 规范抗菌药物临床应用后，医院感染现患率明显降低，防控医院感染取得了显著成效。
ObjectiveTo analyze the trend of hospital infection, so as to provide a scientific basis for hospital infection prevention and control. MethodsFrom 2011 to 2013, according to the criteria of diagnosis of nosocomial infections set up by the Ministry of Health, the prevalence rates of nosocomial infections in patients who were hospitalized on the survey day were investigated by the combination of bedside investigation and medical records checking. ResultsThe incidence rates of nosocomial infections from 2011 to 2013 were 2.99%, 2.31% and 1.95%, respectively, presenting a downward trend. The rate of hospital infection was the highest in comprehensive Intensive Care Unit, and the main infection site was the lower respiratory tract. Gram-negative bacteria were the main pathogens causing hospital infections, including Klebliella pnermoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Escherichia coli. The utilization rates of antibacterial agents in these three years were respectively 39.84%, 34.58% and 34.22%. ConclusionTargeted surveillance and management of key departments and sites should be strengthened. It is necessary to strengthen the surveillance and management of antibiotics, raise the submission rate of pathogens, and use antibiotics appropriately.