关键词: 三级医院, 医院感染, 现患率, 病原菌, 病原学

Abstract: Objective To investigate the prevalence of nosocomial infection and the distribution of pathogenic bacteria in the tertiary hospitals of Enshi City, grasp the trend of nosocomial infection, and provide reference for the subsequent development of scientific management and prevention measures. Methods A cross‐sectional survey was conducted on a fixed survey day every year from 2020 to 2022 to investigate the prevalence of nosocomial infection among all hospitalized patients in three tertiary hospitals in Enshi City. The distributions of departments and infection sites of nosocomial infection were analyzed, and the status of pathogen testing and distribution of pathogens were investigated. Results From 2020 to 2022, a total of 19 597 hospitalized patients were surveyed, with a confirmed investigation rate of 97.17%. The average prevalence of nosocomial infection was 3.01%, with a case prevalence of 3.57%. The prevalence and case prevalence of nosocomial infection in each year were gradually decreased （P<0.05）. In the past three years, the top three departments in terms of nosocomial infection prevalence were Intensive Care Medicine （13.87%）, Hematology （10.39%）, and Neurosurgery （7.11%）; The top three infection sites were the lower respiratory tract （39.48%）, upper respiratory tract （22.46%）, and urinary system （14.02%）. The usage rate of antibiotics was 30.16% during 2020 to 2022, and the usage rate of antibiotics showed a decreasing trend year by year （P<0.01）. The main purpose of using antibiotics was to treat or treat combined with prevent （79.78%）, with the highest proportion of single type antibiotics use （76.84%）. The rate of microbial sample submission before therapeutic use was 53.39%. From 2020 to 2022, the rate of microbial sample submission before antibiotics use showed an increasing trend year by year （P<0.01）. From 2020 to 2022, a total of 1 053 strains of pathogenic bacteria were detected, with Gram‐negative bacteria being the most common, accounting for 60.40%, mainly Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii; The second was Gram‐positive bacteria （32.95%）, mainly Staphylococcus aureus and Enterococcus faecalis. Conclusions From 2020 to 2022, all indicators of nosocomial infection in the tertiary hospitals of Enshi City, Hubei Province were under the control range. However, it is still necessary to strengthen the infection prevention and control work in key departments and high‐risk sites, pay attention to the cultivation of pathogenic bacteria, and improve the rate of pathogen testing.

Key words: Tertiary hospital, Nosocomial infection, Prevalence, Pathogenic bacteria, Etiology