2014年某儿童医院医院感染现患率调查

目的了解儿童医院医院感染现状及抗菌药物使用情况。方法采用床旁调查和查阅病历相结合的方法,调查某儿童医院2014年5月1日0∶00—24∶00住院患者的医院感染现患率及抗菌药物使用情况。结果共调查患者1 027例,发生医院感染8例(10例次),医院感染现患率为0.78%,例次现患率为0.97%。感染科室主要为血液中心(4例),感染部位主要为呼吸道(上、下呼吸道各2例),抗菌药物使用率为62.12%。各科室抗菌药物使用率、抗菌药物用药目的及联合用药方面比较,差异均有统计学意义(均P0.05)。抗菌药物使用率居前3位的科室为新生儿中心(89.69%)、急救中心(76.00%)、综合病房(73.91%);除五官科(预防用药占57.89%)、外科(治疗用药占26.32%),其他科室均以治疗用药为主;五官科、心脏中心及神经康复中心均以单一用药为主(均95%),新生儿中心二联用药率占48.28%,血液中心三联用药率占30.30%。结论儿童医院应重点加强感染高发科室和高发部位的日常监测,加强医护人员的医院感染相关知识培训,合理使用抗菌药物。

Prevalence rate of healthcare associated infection in a children’s hospital in 2014

ObjectiveTo explore the current status of healthcare associated infection (HAI) and antimicrobial use in a children’s hospital. MethodsPrevalence rates of HAI and antimicrobial use among hospitalized patients at 0∶00—24∶00 of May 1, 2014 were investigated by combination of bedside visiting and medical record reviewing. ResultsA total of 1 027 patients were investigated, 8 patients developed 10 times of infection, prevalence rate of HAI was 0.78%, prevalence case rate was 0.97%. HAI mainly occurred in patients in blood center (n=4), the main infection site was respiratory tract（upper respiratory tract, n=2; lower respiratory tract，n=2）, antimicrobial usage rate was 62.12%. Antimicrobial usage rate， purpose of antimicrobial use， and combination use of antimicrobial agents among different departments were all significantly different(all P<0.05).The departments with top 3 antimicrobial usage rates were neonatal center（89.69%）, emergency center（76.00%）, and comprehensive department（73.91%）；except department of ophthalmology otorhinolaryngology stomatology (preventive antimicrobial use accounted for 57.89%) and department of surgery(therapeutic antimicrobial use accounted for 26.32%), the other departments mainly used therapeutic antimicrobial agents; department of ophthalmology otorhinolaryngology stomatology, heart center, and neurological rehabilitation center mainly adopted single medication treatment （all ＞95%），two drug combination rate in neonatal center accounted for 48.28%, three drug combination rate in blood center accounted for 30.30%. ConclusionRoutine surveillance on departments and sites of high HAI incidence should be intensified in children’s hospitals, training on knowledge of HAI among health care workers should be strengthened， and antimicrobial should be used rationally.