目的 了解四川省医疗机构2011年医院感染基本情况,建立医院感染相关指标的参照体系.方法 2011年9月1-30日,四川省248所二级及二级以上医院参与医院感染现患率调查.参与调查的各医院自行确定调查日,采取床旁调查和查阅住院病历相结合的方法,对248所医院调查日(0∶00-24∶00)所有住院患者进行调查.结果 248所医院应查人数75 822例,实查74 457例,实查率98.20%.发生医院感染1 966例,2 001例次,医院感染现患率为2.64%,例次现患率为2.69%.不同规模医院医院感染现患率比较,差异有统计学意义(χ2=46.70,P＜0.01),随着医院规模的增大,医院感染现患率升高.医院感染部位居前3位者依次为呼吸道( 55.77%)、泌尿道(12.79%)和手术切口(11.99%);医院感染现患率较高的科室依次为:肿瘤科(4.52%)、外科(3.28%)和内科(3.02%);医院感染患者病原学送检率为42.13%(843/2 001);调查当日共39 440例患者使用抗菌药物,医院抗菌药物使用率为52.97%,其中11 209例(15.05%)患者预防用药,28 231例(37.92%)患者治疗用药.医院治疗用抗菌药物者送细菌培养率为21.63%(6 105/28 231).结论 此次调查有助于了解四川省各医院医院感染的基本情况,建立各指标的参照体系,供各医院参考比对,可指导医院感染防控工作.%Objective To investigate the prevalence of healthcare-associated infection(HAI) in the healthcare settings of Sichuan province in 2011 , and establish the reference system of HAI indicators. Methods 248 hospitals of Sichuan province participated in HAI prevalence survey in September 1 st-30th, 2011. Hospitals were surveyed for a given day(0 : 00 24 : 00)decided by each hospital, point prevalence of HAI among all hospitalized patients were investigated by combination of bed-visiting and medical records checking. Results 75 822 patients in 248 hospitals should be surveyed, 74 457 patients (98. 20%)were actually surveyed. 1 966 patients had 2 001 times of HAI, HAI rate and case rate was 2. 64% and 2. 69% respectively; HAI prevalence rates of hospitals with different sizes were statistically different (x2 = 46. 70,P＜0. 01), and HAI prevalence rate increased with the increase of hospital size. The top 3 HAI sites were respiratory tract (55. 77%), urinary tract (12. 79%) and surgical site (11. 99%); HAI were high in oncology department (4. 52 %), surgery department (3. 28 %) and internal medicine department (3. 02%); pathogenic detection rate of specimens from HAI patients was 42. 13%(843/2 001) ;39 440 patients used antimicrobial agents on the day of survey, antimicrobial usage rate was 52. 97%, of which 15. 05% (11 209 cases) were prophylactic and 37. 92% (28 231) were therapeutic. Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 21. 63%(6 105/28 231). Conclusion This prevalence survey is helpful for realizing the HAI state in healthcare settings of Sichuan province, and guide the prevention and control of HAI.
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