一所香港医疗大学医院感染的流行.pdfVIP

Journal of Hospital Infection (2007) 65, 341e347 /journals/jhinPrevalence of hospital infection and antibiotic use at a University Medical Center in Hong Kong M.K. Lee*, C.S. Chiu, V.C. Chow, R.K. Lam, R.W. Lai Department of Microbiology, Prince of Wales Hospital, Hong Kong Received 1 August 2006; accepted 8 December 2006 Available online 2 February 2007 KEYWORDS Nosocomial infection; Hospital-acquired infection; Point prevalence survey; Hong Kong Summary Hospital infection prevalence surveys were performed in our 1400-bed University medical centre in Hong Kong from 1985 to 1988. We in- vestigated the rates of four major hospital-acquired infections (HAIs) (pneumonia, symptomatic urinary tract infection, surgical site infection and laboratory-confirmed bloodstream infection) in order to identify cur- rent distribution and any changes after 15 years. A one-day point preva- lence study was performed on 7 September 2005. All inpatients were surveyed for HAIs, community-acquired infections (CAIs), risk factors, patho- genic isolates and antibiotics prescribed. Infections were diagnosed according to Centers for Disease Control and Prevention (CDC) criteria. In total, 1021 patients were surveyed; of these, 41 had 42 HAIs (4% preva- lence) and 389 (38%) were receiving antibiotics. The commonest HAI was pneumonia (1.4%) followed by bloodstream infection (0.9%) and symptom- atic urinary tract infection (0.8%). The prevalence of postoperative surgi- cal site infection was 5.6%. The nosocomial prevalence rate was highest in the Intensive Care Unit, followed by the Pediatric and Neonatal Intensive Care Units, Children’s Cancer Centre/Bone Marrow Transplant Unit and Orthopaedics with Traumatology. Meticillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa were the commonest pathogens. The rates are significantly lower than previously and reflect the increased resources for infection control made available following the outbreak of severe acute respiratory syndrome (SA