2015年云南省116所医院医院感染横断面调查

目的了解云南省2015年医院感染现状，为制订医院感染预防与控制措施提供依据。方法采用床旁调查和病历调查相结合的方法，调查云南省116所医院医院感染现患率、抗菌药物使用情况及病原学送检情况。结果共调查住院患者64 386例，发生医院感染1 357例，1 476例次，医院感染现患率为2.11%，例次现患率为2.29%。不同床位数医院医院感染现患率、抗菌药物使用率和治疗使用抗菌药物病原学送检率比较，差异均有统计学意义（均P＜0.01）。医院感染居前3位的科室依次为重症监护病房（20.99%）、烧伤科（8.00%）及血液科（7.34%）；感染部位以下呼吸道为主（占42.68%）；医院感染病原菌以革兰阴性菌为主（占69.28%），主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌等。调查日抗菌药物使用率为35.62%，治疗性使用抗菌药物病原学送检率为59.56%。结论本次医院感染横断面调查有助于了解全省医院感染现况，计算出各指标的百分位数分布，便于各医院进行医院感染相关工作的自我评价。

Cross sectional survey on healthcare associated infection in 116 hospitals of Yunnan Province in 2015

ObjectiveTo investigate the current situation of healthcare associated infection（HAI）in hospitals in Yunnan Province in 2015, and provide basis for formulating HAI control measures. MethodsA cross sectional survey on HAI prevalence rate , antimicrobial use，and pathogenic detection in 116 hospitals in Yunnan Province were conducted by combined methods of bed side survey and medical record reviewing. ResultsA total of 64 386 hospitalized patients participated in the survey, the prevalence rate of HAI was 2.11%(n=1 357), and case prevalence rate was 2.29%(n=1 476). Difference in prevalence rates of HAI, antimicrobial usage rates, and pathogenic detection among hospitals of different beds were all significant（all P ＜0.01）. The top 3 departments of HAI distribution were intensive care units(20.99%), burn departments（8.00%）, and hematology departments (7.34%) ; the main infection site was lower respiratory tract(42.68%); HAI mainly caused by gram negative bacteria（69.28%）, the major were Escherichia coli , Klebsiella pneumoniae, and Pseudomonas aeruginosa. Antimicrobial usage rate at the survey day was 35.62 %, bacterial detection rate in patients receiving therapeutic antimicrobial use was 59.56%. ConclusionThe cross sectional survey on prevalence of HAI is helpful for understanding the current status of HAI, calculation of the percentile distribution of each index can promote self evaluation for HAI related work in each hospital. ［Key words］healthcare associated infection; cross sectional survey; prevalence rate; antimicrobial agent; pathogen