中医院3年医院感染现患率调查分析

Investigation and analysis of prevalence rates of nosocomial infections in a traditional Chinese medicine hospital in three years

  • 摘要: 目的 了解亚热带地区医院环境表面和人员体表携带菌情况,以指导临床合理使用消毒剂,科学有效地开展医院感染控制工作。方法 2013年10月对解放军总医院海南分院的环境表面、医护人员和患者进行现场采样,同时采用直接接种法和稀释法进行培养,用全自动细菌鉴定质谱仪进行菌种鉴定。结果 在300份标本中共培养阳性115份,阳性率为38.3%;检出革兰阴性菌占53.0%,革兰阳性菌占23.5%,真菌占18.3%,排名前6位为不动杆菌属、凝固酶阴性葡萄球菌、假丝酵母菌属、丝状真菌、肺炎克雷伯菌、肠球菌属,分别占21.7%、12.2%、9.6%、7.8%、7.0%、7.0%;真菌在医院各类仪器设施表面、医护人员和患者体表均有检出。结论 以海南为代表的亚热带地区,气候湿润温暖,医院环境表面和人员中的携带菌分布和其他地区有明显差异,尤其是真菌分布广泛,提示应加强这类环境的消毒清洁工作和重点菌群的预防控制措施。

     

    Abstract: OBJECTIVE To understand the distribution of bacterial flora from the object surface in subtropical hospital environment and personnel body surface so as to reasonably guide clinical use of disinfectants and control hospital infections. METHODS In Oct. 2013,samples were collected from the object surface and body surface(including medical staff and patients) in Hainan branch of Chinese PLA general hospital, meanwhile the direct inoculation method and dilution method were used to culture the bacteria, and mass spectrometer was used for automatic bacteria identification. RESULTS A total of 115 strains of pathogens were isolated from 300 samples with the detection rate of 38.3%. Among them, gram-negative bacteria accounted for 53.0%, gram-positive bacteria accounted for 23.5% and fungi accounted for 18.3%. The top six strains were ranked by Acinetobacter baumannii, coagulase negative Staphylococcus, Candida, flamentous fungi, Klebsiella pneumoniae, and Enterococcus, accounting for 21.7%, 12.2%, 9.6%, 7.8%, 6.9%, and 6.9% respectively. Fungi were isolated both from surface of all kinds of instruments and facilities in the hospital, and medical staff and patients' body. CONCLUSION Hainan, represented by subtropical climate, is warm and wet. The distribution of bacterial flora in environment and personnel body surface is obviously different from other areas. Fungi are widely distributed especially. It suggests that cleaning disinfection, emphasis of prevention and control measures in such kind of environment should be strengthened.

     

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