首页|江苏省不同区域间医疗机构医院感染监控数据差异化分析

江苏省不同区域间医疗机构医院感染监控数据差异化分析

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目的 收集江苏省二、三级医疗机构医院感染监测过程数据并开展不同区域间的对比分析,查找存在差距,为开展有针对性持续改进提供依据。方法 结合等级医院评审、公立医院高质量发展的要求,采用自主上报联合信息化抓取相结合的方式收集2023年1季度江苏省医疗机构医院感染发病率等指标数据,将全省按照位置划分为苏南、苏中和苏北3个区域进行分析,以评价区域水平。结果 共纳入109所医疗机构。其中,三级医院78家、二级医院31家,总体医院感染发病率为0。81%,总体医院感染发病例次率为0。90%,中央导管相关血流感染(central line-associated bloodstream infection,CLABSI)、呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)以及导尿管相关尿路感染(catheter-associated urinary tract infection,CAUTI)发病率分别为 0。113‰、1。553‰、0。424‰,Ⅰ类切口手术预防用药比例及手术部位感染发生率分别为17。72%和0。16%,上述感染指标中除CLABSI和VAP的发病率苏中地区较高外,其余指标均呈现苏南地区依次高于苏中地区高于苏北地区的特点。而住院患者抗菌药物使用率与病原学送检率分别为41。07%和41。50%,苏南、苏北和苏中地区抗菌药物使用率分别为 41。83%、41。51%和 39。51%(x2=446。789,P<0。001),病原学送检率分别为 46。09%、40。94%和 35。09%(x2=3036。865,P<0。001)。在耐药菌感染发现率方面,前3位依次为耐碳青霉烯鲍曼不动杆菌(0。067%)、耐碳青霉烯肺炎克雷伯菌(0。031%)和耐甲氧西林金黄色葡萄球菌(0。029%)。其中,苏南地区耐药菌感染率指标明显高其他两个区域。在检出率方面,耐碳青霉烯鲍曼不动杆菌和耐甲氧西林金黄色葡萄球菌检出率各区域接近(83。77%vs。53。91%),而苏南地区耐碳青霉烯大肠埃希菌(x2=95。619,P<0。001)、耐碳青霉烯肺炎克雷伯菌(x2=520。855,P<0。001)和耐碳青霉烯铜绿假单胞菌(x2=191。918,P<0。001)检出率明显高于苏中地区和苏北地区。结论 江苏省不同区域间医疗机构医院感染监控数据呈现明显的差异性,在强调医院感染监测的同时应开展针对性质量控制反馈与督查整改。
Differential analysis of nosocomial infection surveillance data from medical institutions in Jiangsu Province
Objective To collect the data of nosocomial infection surveillance in secondary and tertiary medical institutions in Jiangsu Province and conduct comparative analysis among different regions to find out the gaps and provide basis for targeted continuous improvement.Methods Combined with the requirements of grade hospital evaluation and high-quality development of public hospitals,the data of nosocomial infection incidence in medical institutions of Jiangsu Province in the first quarter of 2023 were collected by autonomous reporting and information capture,and the province was divided into three regions according to location:South Jiangsu,Central Jiangsu and North Jiangsu for analysis,so as to evaluate the regional level.Results A total of 109 medical institutions were included,including 78 tertiary hospitals and 31 secondary hospitals.The overall incidence rate of nosocomial infection was 0.81%(0.90%).The incidence of central line-associated bloodstream infection(CLABSI),ventilator-associated pneumonia(VAP)and catheter-associated urinarytract infection(CAUTI)were 0.113‰,1.553‰ and 0.424‰,respectively.The proportion of prophylactic drugs in Class Ⅰ incision and the incidence of surgical site infection in Class Ⅰ incision were 17.72%and 0.16%,respectively.In the above infection indicators,the incidences of CLABSI and VAP were higher in Central Jiangsu,while the other indicators were higher in South Jiangsu than in Central Jiangsu than in North Jiangsu.The utilization rate of antibiotics and the detection rate of pathogens in inpatients were 41.07%and 41.50%,respectively.Among South,North,and Central Jiangsu,the utilization rate of antibiotics was 41.83%,41.51%,and 39.51%,respectively(x2=446.789,P<0.001),and the detection rate of pathogens was 46.09%,40.94%,and 35.09%,respectively(x2=3036.865,P<0.001).In the detection rate of drug-resistant bacteria infection,the top 3 were carbapenem-resistant Acinetobacter baumannii(0.067%),carbapenem-resistant Klebsiella pneumoniae(0.031%)and methicillin-resistant Staphylococcus aureus(0.029%).Among them,the infection rate of drug-resistant bacteria in South Jiangsu was significantly higher than that in the other two regions.The detection rates of carbapenem-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus were close to each other(83.77%vs.53.91%),while the detection rates of carbapenem-resistant Escherichia coli(x2=95.619,P<0.001),carbapenem-resistant Klebsiella pneumoniae(x2=520.855,P<0.00 1)and carbapenem-resistant Pseudomonas aeruginosa(x2=191.918,P<0.001)in South Jiangsu were significantly higher than those in Central and North Jiangsu.Conclusions There are significant differences in nosocomial infection surveillance data of medical institutions in different regions of Jiangsu Province.It is emphasized that targeted quality control feedback,supervision and rectification should be carried out while hospital infection monitoring.

Medical institutionregionalnosocomial infectiondatadifferentiation

陈亚男、李阳、宋培新、刘菁

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连云港市第一人民医院感染管理科(江苏连云港 222061)

南京大学医学院附属鼓楼医院感染管理处(南京 210000)

医疗机构 区域性 医院感染 数据 差异化

连云港市医院协会医院管理创新研究重点项目

LYX-Z-202301

2024

华西医学
四川大学华西医院

华西医学

CSTPCD
影响因子:0.744
ISSN:1002-0179
年,卷(期):2024.39(3)
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