目的 了解医院感染现患率及危险因素，及时调整医院感染预防控制措施。 方法 医院感染管理专职人员与临床医师共同调查2010年12月15日0：00～24：00所有住院患者，查阅病历和床旁调查相结合，填写统一的现患率调查个案登记表和床旁调查表，对调查结果进行统计分析。 结果 医院感染现患率2.49%；科室主要分布在综合重症监护病房（ICU）和内三科（肿瘤和内分泌专业）；部位主要分布在下呼吸道、泌尿道、血液；导管相关感染有增加趋势，不合理使用抗菌药物问题较突出。 结论 综合ICU和内三科是新津县人民医院的重点科室；下呼吸道、泌尿道、中心静脉置管部位是重点部位；侵袭类操作及不合理使用抗菌药物是危险因素；该院医院感染预防控制工作重点：加强导管相关感染监测，增加耐药菌监测，加强对综合ICU、内三科的管理，加强对侵袭性操作及合理使用抗菌药物的管理，提高病原学送检率。
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。
Objective To understand the current rate of nosocomial infection and its changing trend in a grade A comprehensive hospital in 10 years, and to provide scientific basis for the monitoring, control and management of nosocomial infection. Methods Using the method of cross-sectional survey, the inpatients in Mianyang Central Hospital from 2011 to 2020 were selected for bedside survey, and the questionnaire was filled in after review of medical records. The data of cross-sectional survey of nosocomial infection were collected, and the infection-related data of nosocomial and community-acquired infection of patients in each department were statistically analyzed. Results A total of 19 595 cases were investigated. The prevalence rate of nosocomial infection was 3.79%, and the the case prevalence rate of nosocomial infection was 4.04%. The prevalence of community-acquired infection was 33.44%, and the case prevalence rate of community-acquired infection was 35.30%. The departments with higher prevalence rate in nosocomial infection were intensive care unit, neurosurgery, cardiothoracic surgery and hematology. The departments with high prevalence rate in the community-acquired infection were burn department, pediatrics department, neonatology department, respiratory medicine department and pediatric intensive care unit. The most common site of nosocomial infection was lower respiratory tract infection, followed by upper respiratory tract sensation, urinary tract, abdominal tissue and blood. The main pathogens of nosocomial infections were Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa. The utilization rate of antibacterial drugs was 42.93%. There was a downward trend in prophylactic drug use, mainly one drug combination, and the proportion of combination drug decreased.Conclusion Through the investigation, it can be seen that the key points of nosocomial infection management and prevention and control should be lower respiratory tract infection, postoperative surgical infection, multi-drug resistant bacteria management and rational use of antibiotics.
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 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 了解医院感染情况，对医院感染控制工作进行评价，为医院感染控制措施提供依据，提高医务人员的感染控制意识。 方法 采用横断面调查的方法，于2012年8月21日进行医院感染现患率调查，将调查结果进行分类、统计、分析。 结果 应查住院患者1 383例，实查1 378例，实查率99.64%，现患率3.41%。医院感染下呼吸道感染占53.19%，泌尿道感染占25.53%，手术部位感染占4.26%，调查当日抗菌药物使用率20.90%。 结论 通过医院感染现患率调查，可快捷地获得全院医院感染的情况，为医院感染防控工作提供依据。
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.
ObjectiveTo investigate the prevalence of nosocomial infection in a hospital and to provide a basis for hospital infection control. MethodsUsing bedside investigation and medical records analysis, we surveyed all hospitalized patients from 00:00 to 24:00 on July 19th, 2013. ResultsThe real investigation was carried out on 1815 patients out of all the 1828 patients with a real investigation rate of 99.29%. There were 55 cases of nosocomial infection (55 case-times), and both the nosocomial point infection rate and case-time infection rate were 3.03%. The top three departments with the highest rate were Intensive Care Unit (37.50%), Neurosurgery Department One (13.73%) and Neurosurgery Department Two (12.00%). Most infections occurred on the lower respiratory tract, which accounted for 45.45%. Nosocomial infection pathogenic detection rate was 38.18% (21/55):6 cases of Staphylococcus aureus (28.57%), 5 of Pseudomonas aeruginosa (23.81%), 3 of Klebsiella pneumoniae (14.29%), and 2 cases of Acinetobacter baumanii (9.52%). The rate of antimicrobial drug use was 24.08%, in which drug treatment accounted for 75.29%. Gender, surgery, urinary catheter, vascular catheter, tracheostomy, ventilator application, hemodialysis, and use of antibiotics were all influencial factors for occurrence of nosocomial infection. ConclusionNosocomial infection prevalence survey can help fully understand the status of hospital infection, help to carry out targeted surveillance, and better guidance for hospital to prevent and control nosocomial infection.
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 learn the current situation and feature of nosocomial infection (NI), so as to provide reference for making the prevention measures. MethodsPrevalence rate of nosocomial infection in patients hospitalized on December 18, 2012 was investigated by the combination of bed-side examination and medical record checking. ResultsA total of 1 083 patients were surveyed, and the prevalence rate of nosocomial infection was 6.00%. Intensive Care Unit had the highest NI prevalence (28.57%), followed by Hematology Department (20.00%) and Neurosurgery Department (20.00%). Lower respiratory tract (38.46%) was the main infection site, followed by superficial surgical incision (13.85%). The usage rate of antimicrobial agents was 30.56%, and 40 strains of pathogens were isolated, in which Klebsiella pneumonia (15.0%), Pseudomonas aeruginosa (12.5%) and Escherichia coli (10.0%) were the main ones. ConclusionTarget monitoring management of key departments and key sites should be strengthened, and the management of antimicrobial agents should be stressed and invasive procedures should be decreased.