南部某區域醫院院內感染調查分析

Survey of Nosocomial Infections at a Regional Hospital in Taiwan

陳淑惠(Shu-Hui Chen) ； 趙玉玲(Yuh-Ling Jaw) ； 張玉雯(Yuh-Wen Jang)

《感染控制雜誌》 13卷6期 (2003/12) Pp. 346-353

https://doi.org/10.6526/ICJ.200312_13(6).0002

摘要

針對過去三年來院內感染個案資料統整分析，藉以了解本院院內感染變化趨勢，作為修訂院內感染管制措施之重要參考依據。根據美國疾病管制中心1988年及1992年所頒佈之院內感染定義收案，本院從1999年至2001年，全院住院人次為39,689人次，其中1,330人次發生院內感染，院內感染發生率為3.4%，發生密度3.1?。各單位發生密度以加護中心23.1?最高，普通病房以六病房5.8?最高，另外呼吸治療病房於90年成立，感染發生密度佔10.7?。感染部位以泌尿道33.6%居高，呼吸道和血流分居第二、三，分別為28.2%和16.9%。主要院內感染致病菌是以Pseudomonas aeruginosa（16.6%）、Oxacillin-resistant Staphylococcus aureus（ORSA）（12.0%）、和Escherichia coli（9.2%）為主。調查過去三年顯示加護單位（加護中心、燒傷中心、小兒加護中心）平均發生密度16.5?，為院內感染高危險單位，院內感染菌種ORSA已逐年增加。從全院各單位、各部位院內感染率及主要菌種分佈的調查及持續性的監測，掌握目前院內感染的流行，以及菌種的變遷，及早發現臨床上的疏失，擬定感染管制措施，加以改善。

關鍵字

區域醫院 ； 院內感染 ； 感染管制措施

並列摘要

We retrospectively analyzed records of cases with nosocomial infections at a Regional Hospital in southern Taiwan covering a 3-yealperiod from 1999 till 2001. Active surveillance of infections according to the definitions of the US Centers of Disease Control and Prevention published in 1988 and 1992 was carried out. There was a total of 39,689 patient discharged, of which 1,330 cases acquired nosocomial infections, with the incidence of 3.35% and the incidence density of 3.09? Of all hospital units, the general intensive care unit (ICU) had the highest incidence density of 23.07? The highest rate among all general wards was 5.8? The respiratory care ward (RCW) that was established in 2001 had the incidence density of 10.69? The urinary tract (33.6%) and respiratory tract (28.21%) were the two most common nosocomial infection sites. The major pathogens found were Pseudomonas aeruginosa (16.6%), oxacillin-resistant Staphylococcus aureus (ORSA) (12.0%), and Escherichia coli (9.3%). For three years, the ICU had the highest infection rate averaged 16.52? By continuous surveillance, we may be able to detect problems early, and design preventative measures to reduce the nosocomial infection rate to the minimum.

並列關鍵字

Regional Hospital ； Nosocomial Infection ； Infection Control