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中国一家三级甲等教学医院对医疗相关感染和抗菌药物使用情况进行的为期8年的现患率监测。

An 8-year point-prevalence surveillance of healthcare-associated infections and antimicrobial use in a tertiary care teaching hospital in China.

作者信息

Wu Yi-Le, Yang Xi-Yao, Pan Meng-Shu, Li Ruo-Jie, Hu Xiao-Qian, Zhang Jing-Jing, Yang Li-Qi

机构信息

Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.

出版信息

Epidemiol Infect. 2018 Oct 25;147:e31. doi: 10.1017/S0950268818002856.

Abstract

Healthcare-associated infections (HAIs) are a major worldwide public-health problem, but less data are available on the long-term trends of HAIs and antimicrobial use in Eastern China. This study describes the prevalence and long-term trends of HAIs and antimicrobial use in a tertiary care teaching hospital in Hefei, Anhui, China from 2010 to 2017 based on annual point-prevalence surveys. A total of 12 505 inpatients were included; 600 HAIs were recorded in 533 patients, with an overall prevalence of 4.26% and a frequency of 4.80%. No evidence was found for an increasing or decreasing trend in prevalence of HAI over 8 years (trend χ2 = 2.15, P = 0.143). However, significant differences in prevalence of HAI were evident between the surveys (χ2 = 21.14, P < 0.001). The intensive care unit had the highest frequency of HAIs (24.36%) and respiratory tract infections accounted for 62.50% of all cases; Escherichia coli was the most common pathogen (16.67%). A 44.13% prevalence of antimicrobial use with a gradually decreasing trend over time was recorded. More attention should be paid to potential high-risk clinical departments and HAI types with further enhancement of rational antimicrobial use.

摘要

医疗保健相关感染(HAIs)是一个全球性的重大公共卫生问题,但关于中国东部地区HAIs及抗菌药物使用的长期趋势的数据较少。本研究基于年度现患率调查,描述了2010年至2017年中国安徽合肥一家三级甲等教学医院HAIs及抗菌药物使用的患病率和长期趋势。共纳入12505名住院患者;533例患者中记录到600例HAIs,总体患病率为4.26%,感染频率为4.80%。未发现8年间HAI患病率有上升或下降趋势(趋势χ2 = 2.15,P = 0.143)。然而,各次调查之间HAI患病率存在显著差异(χ2 = 21.14,P < 0.001)。重症监护病房的HAIs发生率最高(24.36%),呼吸道感染占所有病例的62.50%;大肠杆菌是最常见的病原体(16.67%)。抗菌药物使用率为44.13%,且随时间呈逐渐下降趋势。应更加关注潜在的高风险临床科室和HAI类型,进一步加强抗菌药物的合理使用。

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