目的调查分析某大型综合性医院住院患者的医院感染特点、流行特征及有关影响因素,为制定有效的医院感染管理措施提供依据。方法采用回顾性方法对某大型综合性医院2006-2010年住院患者信息系统相关资料及医院感染监测资料进行汇总分析。结果 2006-2010年住院患者共266 514例,医院感染的发生率逐年下降(χ2=153.25,P=0.000);医院感染漏报率逐年呈下降趋势(χ2=194.82,P=0.000);下呼吸道感染在易感部位的构成中占第1位为35.52%;医院感染与患者年龄的关系呈现不规则"U"型特征;医院感染发生率最高的是8月份,为3.26%,最低的是5月份为2.53%;住院院时间与感染率呈正相关,住院时间60d的患者感染率明显增高;手术与否和医院感染有相关性(χ2=530.54,P=0.000);不同科室之间医院感染发生率有所不同,以血液内科最高为17.25%;检出的病原菌以革兰阴性杆菌为主,占69.6%。结论医院感染的发生与患者年龄、基础疾病、侵入性操作、住院时间、抗菌药物不合理使用等因素有关,建立快速准确的医院感染监测系统,是做好医院感染控制,提高医院感染管理效率的有效方法。
OBJECTIVE To investigate and analyze the nosocomial infections characteristics,prevalence features and the related impact factors of the hospitalized patients in a large-scale comprehensive hospital so as to provide basis for development of effective management measures for nosocomial infections.METHODS A retrospective analysis of the related clinical data of the hospitalized patients in a large comprehensive hospital from 2006to 2010 was performed.RESULTS From 2006 to 2010,there were totally 266514 patients investigated,the incidence of nosocomial infections decreased year by year(χ2=153.25,P=0.000);the missing report rate of nosocomial infections declined year by year(χ2=194.82,P=0.000);the lower respiratory tract ranked the first place(35.52%) among the susceptible infection sites;the relationship between the nosocomial infections and the age of the patients presented as the irregular feature of U;August was the peak of nosocomial infections with the incidence rats of 3.26%,May the lowest(2.53%);there was a positive correlation between the hospital stay and the infection rate,the infection rate of the patients with the hospital stay more than 60 days increased significantly;there was a correlation between the surgery and the nosocomial infections(χ2=530.54,P=0.00);the incidence rate of nosocomial infections varied in clinical departments,the incidence rate was highest in department of blood medicine(17.25%);gram-negative bacilli were the predominant pathogens isolated,accounting for 69.6%.CONCLUSION Nosocomial infection is correlated with the age,underlying diseases,invasive operation,and irrational use of antibiotics;it is an effective way to establish a rapid and accurate nosocomial infection surveillance system so as to control nosocomial infections and improve the efficiency of nosocomial infection management.