目的 探讨专项调查重点科室医务人员手卫生依从性及知识知晓情况结合院感信息系统在降低医院感染中的应用效果。方法 选取2018年1月—2020年12月本院重点科室收治的患者527例,根据入院时间进行分组,对照组采取常规院感管理,观察组采取基于院感信息系统的管理方式,并对重点科室的100名医务人员手卫生依从性及相关知识知晓情况进行专项调查,比较2组医务人员手卫生依从性、手卫生知识知晓程度及医院感染率的差异。结果 观察组医务人员执行各项操作的手卫生依从性、手卫生知识评分均高于对照组(P<0.05);观察组患者医院感染率低于对照组(P<0.05)。结论 采用专项调查重点科室医务人员手卫生依从性及知识知晓结合院感信息系统,能有效提高医务人员的手卫生依从性及相关知识知晓程度,降低医院感染的发生风险。

Objective To discuss the effect of applying special investigation on the hand hygiene compliance and knowledge of medical staff in key departments combined with nosocomial infection information system in reducing nosocomial infections. Methods A total of 527 patients admitted to the key departments from January 2018 to December 2020 were selected, and were grouped according to the time of admission.The control group received routine nosocomial infection management, and the observation group received the management based on nosocomial infection information system.A special survey of hand hygiene compliance and related knowledge was carried out on 100 medical staff in those department, and the differences in hand hygiene compliance, hand hygiene knowledge and nosocomial infection rates between the two groups were compared. Results The hand hygiene compliance and hand hygiene knowledge scores of the medical staff in the observation group were significantly higher than those in the control group (P<0.05). The infection rate of observation patients was lower than control patients (P<0.05). Conclusions The use of special survey on hand hygiene compliance and knowledge of medical staff in key departments combined with nosocomial infection information systems can effectively improve medical staff's hand hygiene compliance and related knowledge, reduce the risk of nosocomial infections, which is worthy of promotion.

目的 探讨脑卒中患者多重耐药菌（MDROs）医院感染风险因素,并进行病原学特点分析。方法 选择2020年1月—2022年12月福建中医药大学附属福鼎医院神经内科病房收治的160例脑卒中患者为研究对象,评估患者的MDROs医院感染发生状况,调查患者的一般资料并进行多因素分析。结果 在160例患者中,发生医院感染20例,分离到病原体26株,其中8例样本为MDROs（研究组,其他归为对照组）,来源于8例患者,占比5.00%,包括耐甲氧西林金黄色葡萄球菌（MRSA）3株,耐碳青霉烯大肠埃希菌（E.coli）2株、耐碳青霉烯肺炎克雷伯菌（KP）1株、全耐药KP1株、耐碳青霉烯PA1株。研究组的美国国立卫生院神经功能缺损（NIHSS）评分、急性生理学和慢性健康状况评价Ⅱ（APACHEⅡ）评分、糖尿病、低蛋白血症、置管留置时间、住院时间等与对照组对比差异有统计学意义（P<0.05）。二分类Logistic回归分析显示,上述指标均为导致MDROs医院感染发生的重要因素（P<0.05）。结论 脑卒中患者MDROs医院感染的发生率依然比较高,病原菌多为耐甲氧西林MRSA、耐碳青霉烯E.coli,患者的NIHSS评分、APACHEⅡ评分、糖尿病、低蛋白血症、置管留置时间、住院时间为主要的MDROs感染风险因素。

目的 了解医院感染及抗菌药物使用现状,进一步制定有效的预防控制措施。方法 采用横断面调查方法,应用SPSS 17.0行统计分析。结果 3次调查实查率100%。其中社区感染255例,现患率31.14%;高发科室为儿科;感染部位以下呼吸道为主(62.75%);感染病原以革兰氏阳性菌(G⁺)为主。医院内感染6例、现患率0.73%;高发科室为妇产科、外科;感染部位以浅表切口为主(50%);感染病原以革兰氏阴性菌(G^-)为主(66.6%)。三年内医院抗菌药物平均使用率32.23%。结论 调查结果反映了医院感染及抗菌药物使用现状。依此制定干预措施,防控多重耐药菌感染,减少医院感染发生。

Objective To investigate the trends of nosocomial infections and use of antimicrobial agents,in order to effectively prevent and control program of hospital infection. Methods Cross-sectional survey method was adopted,the SPSS17.0 were used to statistical analysis. Results The check real rate was 100％.Among them 255 cases were community infection, the infection rate was 31.14%; the high frequent incidence was in the pediatric department; lower respiratory tract infection was the primary infection sites(62.75%);gram-positive bacteria (G +) was the main pathogenic bacteria. 6 cases were nosocomial infection, the infection rate was 0.73%; the obstetrics and gynecology /surgery were the primary incidence; superficial incisional wound infection was the primary infection sites(50%);gram-negative bacteria (G-) was the main pathogenic bacteria(66.6%).The antimicrobial drug utilization rate averaged 32.23% in the three years. Conclusion The investigation reflects the nosocomial infection rates and the present situation of the use of antibacterial drugs. intervention measures were formulated based on the results of the survey. multiple drug-resistant bacteria infection should be prevented and controlled to reduce the incidence of hospital infection.

目的 了解老年患者医院感染的发生情况及相关因素,为有效降低医院感染提供临床依据。方法 对我院2010年6月—2014年6月452例60岁以上的老年患者医院感染情况进行回顾性分析,调查并分析其年龄、住院天数、医院感染部位及相关因素。结果 老年患者医院感染的发生与年龄增长、住院天数延长、感染部位、基础病及抗生素不合理应用等因素密切相关。结论 根据医院感染的相关因素,对老年人加强病房管理及基础护理,不仅改善治疗操作中易感染的环节,减少感染途径,还可以降低医院感染发生率。

目的 调查重症监护病房(ICU)医院感染的常见细菌分布及耐药性变化,为合理使用抗生素和医院感染的预防控制提供相关科学依据。方法 回顾性分析医院2007—2011年ICU收治的381医院感染患者感染菌株分布特点及耐药性情况。结果 ICU医院感染常见菌株主要来源于痰液标本,占78.2%,其次是血液。381 株临床分离菌中共检出革兰阴性杆菌262 株、革兰氏阳性球菌70例和真菌49例,分别占68. 8%、24.9%和占17.4%。革兰阴性杆菌中鲍氏不动杆菌(24.7%)、肺炎克雷伯氏杆菌(10.8%)、铜绿假单胞菌(9.2%)排前三位。其中除碳青霉烯类药物及抑酶制剂,鲍氏不动杆菌对其余抗菌药物耐药率均＞40%。革兰氏阳性球菌以金黄色葡萄球菌为主。对青霉素、庆大霉素、红霉素的耐药率均＞50%。结论 呼吸道仍是ICU最常见的感染部位。病原菌以革兰阴性杆菌为主,且对常用抗菌药物的耐药率逐渐升高,临床应加强抗菌药物规范使用,避免耐药菌株的产生。

Objective To investigate the distribution and drug resistance of pathogens in intensive care unit(ICU)causing nosocomial infections so as to provide scientific basis for antibiotic adoption and the prevention and control of nosocomial infections. Methods The specimen sources and the clinical distribution of the 381 pathogens isolated from 2007 to 2011 were retrospectively analyzed. The drug resistance was observed in ICU that causing nosocomial infections. Results The sputum was the major specimens source in ICU, accounting for 78.2%. Of the 381 pathogens causing nosocomial infections in ICU, the 262 gram-negative bacilli (68.8%), 70 gram-positive cocci (24.9%),and 49 fungi (17.4) were isolated, Among gram-negative bacilli the top three were acinetobacter baumannii (24.7%), klebsiella pneumonia(10.8%),and pseudomonas aeruginosa (9.2%). The drug resisitance rate of baumannii to antibiotics were more than 40%,beside carbapenem and B-Lactamaseinhibitors. The main gram-positive cocci of causing nosocomial infections was saphylococcus aureus in ICU. The drug resisitance rate of S. aureus to penicillin, erythromycin and gentamicin were higher than 50.0%. Conclusion The main distribution area of nosocomial infections was the respiratory tract and the gram-negative bacilli were the common pathogens in ICU. It was benefit to avoid presenting of drug resistant strain, and antibiotics should be reasonably used in clinic.

目的 探讨2型糖尿病患者发生医院感染危险因素。方法 收集2010年1月—2015年1月我院收治890例2型糖尿病患者临床资料行回顾性分析,根据是否发生医院感染分为感染组(75例)和非感染组(815例),对两组患者相关因素进行分析。结果 2型糖尿病医院感染发生率为8.43%,好发于呼吸系统感染。年龄、病程、住院时间、血糖控制差、侵袭性操作、合并并发症、合并基础疾病为2型糖尿病患者发生感染的危险因素。结论 2型糖尿病患者发生医院感染危险因素较多,临床针对高危患者应重点进行预防,降低感染率,提高患者治疗效果。