摘要
目的分析厦门市医院感染长期变化趋势与特点,为精细化感染控制提供循证依据。方法采用现况调查方法,纳入2015—2023年厦门市市属二级及以上且床位数>150张的医疗机构进行医院感染现患率调查,内容包括调查日所有住院患者的感染情况、病原菌分布以及抗菌药物使用情况等信息。分别采用SAS 9.4与Graphpad软件进行数据统计分析。结果9年间,厦门市2015—2023年平均医院感染现患率为2.54%(3286/129138),医院感染现患率呈下降趋势(Z=-6.460,P<0.001),床位数<300张的医院感染现患率呈上升趋势(Z=2.702,P=0.007),300~599、≥900张的医院感染现患率显著降低(Z=-2.265、-7.872;P=0.024、<0.001)。医院感染部位前两位分别为呼吸系统、泌尿系统,呼吸系统感染和手术部位感染率呈下降趋势(Z=5.514、2.310,P<0.001、0.021);血液系统感染率呈上升趋势(Z=-5.900,P<0.001)。Ⅱ、Ⅲ类切口手术部位感染率呈波段下降趋势(Z=-2.152、-2.084,P=0.031、0.037),床位数≥900张的医院Ⅰ类切口手术部位感染率波段式降低(Z=-2.268,P=0.023)。医院感染病原菌以铜绿假单胞菌、大肠埃希菌为主,但其构成比均呈下降趋势(P<0.05)。抗菌药物平均使用率为27.32%,有下降趋势(P<0.05),但治疗性抗菌药物使用率逐年增多(P<0.05),治疗性抗菌药物使用前病原学送检率由63.08%上升至78.28%(P<0.05)。结论厦门市医院感染逐步得到有效控制,但仍应加强小规模医院院感管理培训与落实,并重点做好手术部位和血液系统感染防控。
OBJECTIVE To investigate the long-term changing trends of prevalence rate of hospital-acquired infection in Xiamen and analyze the characteristics so as to provide evidence-based foundation for refined control of infection.METHODS By means of prevalence survey,the prevalence rates of hospital-acquired infections were investigated for the secondary or above municipal medical institutions with the number of beds more than 150 in Xiamen from 2015 to 2023.The prevalence rates of infections among all hospitalized patients,distribution of pathogens and use of antibiotics were included in the survey.The statistical analysis was performed by using SAS 9.4 and Graphpad software.RESULTS The average prevalence rate of hospital-acquired infection was 2.54%(3286/129138)in Xiamen during the 9 years from 2015 to 2023,the prevalence rate of hospital-acquired infection showed a downward trend(Z=6.460,P<0.001);the prevalence rate of hospital-acquired infection of the medical institutions with less than 300 beds showed an upward trend(Z=2.702,P=0.007),and the prevalence rates of hospital-acquired infections were significantly decreased in the medical institutions with the number of beds ranging between 300 and 599 and the medical institutions with no less than 900 beds(Z=2.265,7.872;P=0.024、<0.001).Respiratory system and urinary system were the top 2 infection sites.The incidence rates of respiratory system infection and surgical site infection showed downward trends(Z=5.514,2.31,P<0.001,0.021);the incidence rate of blood system infection showed an upward trend(Z=5.900,P<0.001);the incidence rates of type Ⅱ and Ⅲ surgical incision infections showed waveband downward trends(Z=2.152,2.084,P=0.031,0.037);the incidence rate of type I surgical incision infection showed a waveband downward trend in the medical institutions with the number of beds no less than 900(Z=2.268,P=0.023).Pseudomonas aeruginosa and Escherichia coli were dominant among the pathogens causing the hospital-acquired infection,however,the constituent ratios showed downward trends(P<0.05).The average utilization rate of antibiotics was 27.32%,showing a downward trend(P<0.05);however,the utilization rate of therapeutic antibiotics was increased year by year(P<0.05);the etiological submission rate was increased from 63.08%to 78.28%before the use of therapeutic antibiotics(P<0.05).CONCLUSION The hospital-acquired infections have been effectively under control in Xiamen,but it is still necessary to strengthen the training of infection control in small-scale hospitals and focus on the prevention and control of surgical site infection and blood system infection.
作者
黄蕾
陈德钦
吴杰龙
秦维霞
黄辉萍
HUANG Lei;CHEN De-qin;WU Jie-long;QIN Wei-xia;HUANG Hui-ping(The First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361003,China;不详)
出处
《中华医院感染学杂志》
北大核心
2025年第2期270-275,共6页
Chinese Journal of Nosocomiology
基金
厦门市医疗卫生指导性项目(3502Z20224ZD1010)。
关键词
医院感染
监测
现患率
长期
现况调查
Hospital-acquired infection
Surveillance
Prevalence rate
Long term
Prevalence survey
