頁籤選單縮合
題名 | 某區域醫院院內感染之流行病學調查=Epidemiological Survey of Nosocomial Infections at a Regional Hospital in Taiwan |
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作者 | 林姬妙; 林宛儀; 張上淳; | 書刊名 | 院內感染控制雜誌 |
卷期 | 7:6 1997.12[民86.12] |
頁次 | 頁340-348 |
分類號 | 419.38 |
關鍵詞 | 院內感染; 感染率; Nosocomial infection; Infection rate; |
語文 | 中文(Chinese) |
中文摘要 | 為瞭解位於臺灣東北部某區域教學醫院的院內感染狀況,並探討院內感染與使用侵入性導管之相關性以及得到多次院內感染之情形,故收集該院於民國 1992年7月1日到1995年6月30日,三年間所有的院內感染個案加以統計分析。三年來計有68,083個人次住院,總住院人日數為784,107,有1,995位病人發生院內感染,合計之院內感染人次為2,638人次,平均感染率為3.9%,發生為3.4;每個院內感染病人平均得到1.3次院內感染。從這些病人身上合計分離出2224株致病菌,每個院內感染病人平均得到 1.2株致病菌感染;分離出的菌株中,以革蘭氏陰性桿菌居多,佔58.4%,革蘭氏陽性球菌佔24.3%,黴菌佔13.4%,厭氧菌及其它菌各佔1%,2.9%。院內感染病人年齡從1歲到105歲,中位年齡為65歲,男性佔57.7%,女性佔42.3%。常見感染部位依序為:泌尿道感染(31.7%),呼吸道感染(15.2%),外科部位感染(14.9%)。最常見的三種致病菌為Pseudomonas aeruginosa(15.0%),E.coli(14.8%)及Staphylococcus aureus(10.7%)。加護病房與一般病房之院內感染率分別為12.7%,3.2%;加護病房與一般病房的病人得到兩次或兩次以上院內感染的比例分別為30.6%,18.6%,在統計學上為有意義的差別(P<0.05)。病人從住院到得到院內感染的住院日數(中位數)為17天,依感染部位的不同從14-21天不等。不同感染部位之病人使用侵入性導管之情形為:在泌尿道感染的病人中,使用留置導尿管者佔71.5%,發生血流感染的病人中,使用中心靜脈導管者佔43.8%,在呼吸道感染的病人中,接受氣管內插管者佔21%;而加護病房的病人在泌尿道感染、血流感染及呼吸道感染中,使用侵入性導管的機會比一般病房為高,具有統計學上的相關(P<0.05)。住內科系病房的病人比外科系病房的病人,較容易得到兩次或兩次以上的院內感染。由本研究分析得以瞭解院內感染發生的概況,並更加確認實施院內感染監視的重要性,而定期或不定期的在職教育,讓醫院工作同仁及病人、家屬訪客能瞭解院內感染的重要性,進而配合醫院的感管政策與措施,以減少院內感染的發生,實是當務之急。 |
英文摘要 | We retrospectively collected and analyzed the data of nosocomial infections at Lo-Tung Poh-Ai Hospital, a regional hospital with 750-bed capacity located at northeastern Taiwan, from July 1,1992 to June 30,1995. During these three years, the hospital-wide surveillance of nosocomial infections at this hospital was carried out by two full-time infection control nurses. Of the total of 68,083 admissions with 784,107 patients-days, there were 2,638 nosocomial infections occurring in 1,995 patients. The infection rate was 3.9% and the infection density was 3.4 infections/1,000 patients-days. From these cases, 2,224 pathogens were isolated. Of these, Gram-negative bacilli accounted for 58.4%, Gram-positive cocci, 24.3%, fungi, 13.4%, and anaerobes and other pathogens, 1% and 2.9%, respectively. The ago of these nosocomially infected patients ranged from 1 to 105 years old with a median of 65 years. The male to female ratio was 57.7:42.3. The most common infection site was the urinary tract (31.7%), followed by the respiratory tract (15.2%) and surgical sites (14.9%). The most common pathogen was Pseudomonas aeruginosa (15.0%), followed by Escherichia coli (14.8%) and Staphylococcus aureus (10.7%). The nosocomial infection rates of patients in ICU and general wards were 12.7% and 3.2%, respectively. Of these two groups of patients, the incidence of those who had 2 or more infections were 30.6% and 18.6%, respectively (p<0.05). The median duration from the day of admission to the onset of the infection was 17 days for a total of 2,638 infections. Among those who got urinary tract infections, 71.5% had indwelling urinary catheters. Of those with blood stream infections, 43.8% had central venous catheter insertion. Of those with respiratory tract infections, 21% received endotracheal intubation. There were higher proportions patients who received the invasive procedures among those nosocomially infected patients who stayed in ICU than those who did not. Patients who stayed in the medical wards had a higher proportion of multiple nosocomial infections than those in the surgical wards. These data may be helpful for the education and the planning of future strategies in preventing nosocomial infections. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。