住院患者医院感染现况调查分析.docVIP

???? 住院患者医院感染现况调查分析 ???? ???? 【提　要】　目的　了解我院医院感染(NI)现况.方 法 　抽检503例住院患者病历作现况调查，调查项目有年龄、性别、住院天数、NI率、NI分布 、感染部位、ICU因素、侵入性诊疗操作、免疫抑制剂、广谱抗生素、化疗、放疗、输血或 血制品、恶性肿瘤、慢性病、肝硬化、糖尿病、血液病、尿毒症、昏迷、老年人、新生儿、 一次性医疗用品、手术伤口类型、病原学检查.结果 　NI率为8.75% ，其中下呼吸道感染38.64%、胃肠道感染22.73%、上呼吸道感染13.64%, 泌尿道感染、 真菌感染和术后感染均为6.82%.培养出病原菌主要为铜绿假单胞菌23.53% 、真 菌、肺炎克雷伯菌均为17.65%, 大肠杆菌11.76%.调查前被认为的相关危险 因素和易感因素 经Logistic回归分析有显著性意义(p0.05).结 论　我院NI率低于全国平均水平，NI主要是 下呼吸道感染，其发生主体是中枢神经系统疾病患者，神经内外科病房应该作为NI监控的重 点，应针对较多见的铜绿假单胞菌加强预防及应对措施.应严格限制侵入性诊 疗操作，合理 应用抗生素和免疫抑制剂，尽量减少血液制品的输注，加强对慢性病、肿瘤、老年人和新生 儿护理等.【关键词】　医院感染　现况调查［中分类号］　R 195.4　　　［文献标识码］　A　　　［文章编号］　 1008-634X(2000)04-0274-03 The Field Survey and Analysis of the Nosocomial Infection for 503 Cases of Inpatients YE Xiao-guang　LIN Hong-Yan　SHEN Huai-lian（Department of Infectious Diseases,the Second Affiliated Hospital of Guangzhou medical College ,Guangzhou 510260 China） 【Abstract】　Objective　To investigate the nosocomial infection(NI) in our hospital and to find out the control method. Methods　503 p atients by retrospective sampling studied for NI were carried out during Jan. 2000～Feb.2000.The survey items were:NI rate,NI distribution ,infection site,ICU,urinary intubation, A-V intubation endoscope,trachea intubation,respirator,dial ysis,encephalocoel intubation,immunizing inhibitor,wide spectrum antibiotics,blo od-transfusion,carcinoma,liver cirrrhosis,diabetes,hematopathy,uremia,coma,elde rx,neonate,single use medical material,wound type,etiology check,cultivated resu lt,drug sensity,etc.Results　NI rate of our hospital was 8.75%,which distributed to those:38.64% were lower breath duct infection,22.7 3% were gastro-intestine infection,13.64% were upper breath duct infection,6.8 2% were urineary infection.The result showed that the germs mainly wer e Ps. aeruginosa ,Fungus,Klebsiella pneumoniae,Escherichia coli which were 23.53%,17.65%,17.65% and 11.76% respectively.Multi-variable logistic regression indicated that those assoiate danger factor had great signif icance(p0.05). Con