医院感染诊断病原学送检标本与目标感染部位的匹配情况

Matching of specimens sent for diagnostic pathogenesis of nosocomial infection to the target sites of infection

    摘要
  • 摘要:
    目的 研究医院感染诊断病原学送检标本与目标感染部位的匹配情况。
    方法 纳入2021年1月1日-2021年12月31日南京医科大学第一附属医院发生医院感染的住院患者，纳入2 591例医院感染患者，包含2 827个感染诊断，分析医院感染诊断相关病原学送检率、医院感染诊断相关病原学送检标本匹配率、不同感染部位医院感染诊断相关病原学送检标本匹配率。
    结果 全院医院感染率为1.53%(2 951/192 584)，医院感染诊断相关病原学送检率为95.72%(2 480/2 591)；不同片区间送检率差异有统计学意义(P＜0.001)，其中ICU的医院感染诊断相关病原学送检率最高(99.83%)，外科组(93.09%)和急诊组(91.30%)相对较低；全院医院感染诊断相关病原学送检标本匹配率为87.44%，不同片区间匹配率差异有统计学意义(P＜0.001)，其中ICU最高(94.61%)，内科最低(76.27%)，其中血液科为76.69%(181/236)；医院感染诊断相关病原学送检标本匹配率最高的三个感染部位分别为血液系统(98.13%)、泌尿系统(92.97%)和手术部位(87.56%)；送检标本匹配率＜80%的感染部位主要有皮肤与软组织和眼耳鼻喉部位感染。
    结论 不同科室与不同部位医院感染送检标本的匹配性差异较大，医疗机构应根据不同科室以及不同感染部位的特点采取针对性改进措施，提高医院感染送检标本匹配率，进一步提升抗菌药物合理使用。

     

    Abstract:
    OBJECTIVE To study the matching of specimens sent for diagnostic etiology of nosocomial infection to the target sites of infection.
    METHODS Inpatients with nosocomial infection in the First Affiliated Hospital of Nanjing Medical University from Jan. 1, 2021 to Dec. 31, 2021 were enrolled. A total of 2 591 patients with nosocomial infection were included, containing 2 827 diagnoses of infection. The delivery rate of nosocomial infection diagnosis-related pathogens, the matching rate of specimens related to the diagnosis of nosocomial infection, and the matching rate of specimens related to the diagnosis of different infection sites were analyzed.
    RESULTS The overall nosocomial infection rate was 1.53% (2 951/192 594), and the rate of nosocomial infection diagnosis-related pathogen delivery was 95.72% (2 480/2 591). There was a significant difference in the delivery rate between the different regions of the hospital (P < 0.001), with the ICU having the highest rate of nosocomial infection diagnosis-related pathogen delivery (99.83%), and the surgery group (93.09%) and the emergency group (91.30%) being relatively low. The matching rate of pathogenicity related specimens sent for diagnosis of nosocomial infection in the whole hospital was 87.44%, and the matching rate between different sections was significantly different (P < 0.001), with the highest in ICU (94.61%), the lowest in internal medicine department (76.27%), and 76.69% (181/236) in hematology department. The three sites of infection with the highest matching rates for diagnostic-related pathogenetic specimens sent for testing were the hematologic system (98.13%), the urinary system (92.97%) and the surgical site (87.56%). The infection sites with a matching rate of less than 80% for specimens sent for testing were mainly skin and soft tissues (72.97%) and eye, ear, nose and throat (64.71%).
    CONCLUSION The matching rates of nosocomial infection specimens sent for testing from different departments and different sites were quite different. Medical institutions should take targeted measures according to the characteristics of different departments as well as different infection sites to improve the matching rates of nosocomial infection specimens sent for testing, and further enhance the rational use of antibiotics.

     

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