目的 分析河南省某三级甲等专科医院医院感染特征及变化趋势,为制定有针对性的医院感染防控措施提供依据.方法 通过蓝蜻蜓医院感染实时监测系统收集2018-2023年河南省某三级甲等专科医院住院患者信息,分析医院感染率、医院感染的科室分布、感染部位分布及病原菌种类.结果 2018-2023年共监测住院患者221 550人,发生医院感染1 226例,医院感染率为0.55％,医院感染率由2018年的0.91％下降至2023年的0.40％,呈逐年下降趋势(x2趋势=107.412,P＜0.05);医院感染率排名前2位的科室为重症监护室(intensive care unit,ICU)(1.14％)和心血管外科(0.92％);医院感染部位以下呼吸道(44.10％)为主,其次是上呼吸道(13.84％)、血液系统(14.62％)和手术部位(10.32％);共检出的726株病原菌中,革兰阴性菌567株,占78.10％,其中构成比排名前3位的为肺炎克雷伯菌(26.86％)、鲍曼不动杆菌(16.12％)和铜绿假单胞菌(11.57％);革兰阳性菌136株,占18.73％;真菌23株,占3.17％.结论 应重点关注患者下呼吸道和革兰阴性菌引起的感染,加强医院感染率高发科室ICU和心血管外科的干预和管理,强化医院感染监测工作,减少医院感染的发生和传播.
Analysis of nosocomial infection surveillance in a grade Ⅲ level A hospital in Henan Province,2018-2023
Objective To analyze the characteristics and trends of nosocomial infection in a Grade Ⅲ Level A hospital over six years and propose recommendations for improvement,so as to provide a basis for the prevention and control of nosocomial infections.Methods Inpatient data from a grade Ⅲ level A hospital in Henan were collected from 2018 to 2023 using the real-time Dragonfly Hospital Infection Monitoring System.The analysis included nosocomial infection rates,the departmental distribution,infection sites,and pathogenic bacteria.Results A total of 221 550 patients were monitored with 1 226 cases of nosocomial infections,yielding an infection rate of 0.55％.The infection rate showed a significant downward trend,from 0.91％in 2018 to 0.40％in 2023(x2 趋势=107.412,P＜0.05).The intensive care unit(ICU)and cardiovascular surgery departments had the highest infection rates at 1.14％and 0.92％,respectively.The most common infection sites were the lower respiratory tract(44.10％),upper respiratory tract(13.84％),blood system(14.62％),and surgical site(10.32％).Gram-negative bacteria accounted for 78.10％of the strains,with Klebsiella pneumoniae(26.86％),Acinetobacter Bowman(16.12％),and Pseudomonas aeruginosa(11.57％)being the top three pathogens.Gram-positive bacteria made up 18.73％of the strains,and fungi accounted for 3.17％.Conclusions Emphasis should be placed on infections caused by lower respiratory tract and Gram negative bacteria.Intervention and management in the ICU and cardiovascular surgery department,which have high infection rates,should be strengthened.Hospital infection monitoring should be enhanced to reduce the incidence and spread of nosocomial infections.
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