الملخص
Objective To investigate the implementation of surveillance,prevention and control measures for healthcare-associated infection(HAI)in maternal and child healthcare(MCH)institutions,and provide policy evi-dence for optimizing HAI prevention and control in MCH institutions.Methods Stratified sampling was conducted among the MCH institutions at provincial,municipal and county levels in 8 provinces/autonomous regions.A uni-fied questionnaire was designed and the online survey was conducted through"Questionnaire Star".Results The data from 123 MCH institutions were included in the analysis.90.24％of the MCH institutions carried out compre-hensive surveillance on HAI.The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit(NICU),surgical site infection,multidrug-resistant organisms(MDROs)and HAI in intensive care units(non-NICU excluded)were 89.66％,85.96％,80.77％,and 74.19％,respectively.51.22％MCH institutions adopted information surveillance system on HAI cases.94.31％MCH institutions carried out surveillance on hand hygiene compliance.Over 90％MCH institutions carried out surveillance on environment hy-giene in high-risk departments.71.54％MCH institutions conducted centralized cleaning,disinfection,sterilization and supply for reusable medical instruments in the central sterile supply department(CSSD).Over 90％MCH insti-tutions established three-level pre-examination triage systems.86.18％set up transitional wards.MCH institutions generally adopted a management model with established effective communication,full appointment visits,and sepa-rate visits for special medical groups,such as registered pregnant women,high-risk newborns,healthcare groups,and long-term rehabilitation patients.However,the ratio of institutions conducting on-line follow-up visits was less than 50％.Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI.Information surveillance need to be facilitated.Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions.The cleaning,disinfection,sterilization,and supply processes of reusable medical devices in a few MCH institutions are not standardized.Special medical populations get effective management.On-line healthcare is to be further promoted.
الملخص
Objective To investigate prevalence of healthcare-associated infection(HAI) and community associated infection(CAD in hospitalized patients in Hebei Province.Methods A certain day from August 17 to August 28,2015 was selected as the survey day,unified questionnaires were formulated,the prevalence of HAI and CAI in hospitalized patients in secondary and above comprehensive hospitals in Hebei Province was surveyed,pathogens causing infection were analyzed and compared.Results A total of 65 065 patients in 253 hospitals were surveyed,prevalence rates of HAI and CAI were 2.89％ and 16.84％ respectively.The top three sites of HAI were respiratory tract(61.32％),urinary tract(12.49％),and surgical site(9.83％),the top three sites of CAI were respiratory tract (56.70％),urinary tract(10.89％),and gastrointestinal tract(8.35％).Distribution of sites of HAI and CAI was significantly different(P＜0.01).The top 5 pathogens were of the same species,but ranked differently,the main bacteria causing HAI was Pseudomonas aeruginosa (22.69％),CAI was Escherichia coli (23.79％).There was significant difference in the distribution of pathogens between HAI and CAI (P＜0.01).There were significant differences in pathogenic species causing respiratory tract,gastrointestinal tract,urinary tract,and intra abdominal infection(all P＜0.05).Isolation rates of extended spectrum β-lactamase-producing/carbapenem-resistant Klebsiella pneumoniae,methicillin-resistant Staphylococcus aureus between HAI and CAI were all significantly different(all P ＜0.001).Conclusion Incidence of infection,infection sites,as well as constituent of pathogens and multidrugresistant organisms between HAI and CAI are varied,besides monitoring on HAI,monitoring on drug resistance of pathogens causing CAI should be paid attention,so as to provide scientific basis for rational antimicrobial use in clinical practice.