摘要
目的了解综合性ICU中导管相关性医院感染的发病率及相关因素。方法参照美国医院感染监测系统的标准,前瞻性收集2008年1月-2009年7月入住急救科ICU患者的医院感染及相关数据。结果从2008年1月-2009年7月共收治384例ICU患者,平均住ICU(16.8±38.8)d,平均动静脉置管(11.3±30.3)d,平均机械通气(11.4±39.1)d,平均留置导尿(12.6±33.3)d;共有66例发生医院感染,感染率为19.0%;肺部、尿路和血流是最常见的医院感染部位,占医院感染例次的62.7%,均为导管相关性医院感染;患者的动静脉置管、机械通气、导尿管使用分别为68、68、75 d,留置导管相关性血流感染、呼吸机相关性肺炎和尿路感染的发生率分别为5.1‰、7.8‰、5.8‰,革兰阴性菌仍是医院感染的主要致病菌,占68.8%,假丝酵母菌属占14.3%。结论我国导管相关性医院感染的状况明显好于发展中国家的同类ICU,却明显比不上美国的同类ICU水平;仍需切实加强医院感染的监控,医护人员仍应加强对医院感染预防控制指南的依从性。
OBJECTIVE To investigate the incidence and related factors of device-associated nosocomial infection in general ICU. METHODS According to the definitions of National Nosocomial Infections Surveillance System, nosocomial infection and related data in ICU patients of general ICU in Shanghai Changzheng Hospital from Jan. 2008 to July 2009 were prospectively collected. RESULTS Totally 384 patients were admitted to ICU. Mean ICU duration was 16. 8 ±38. 8 days. Mean artery/central line catheterization day was 11. 3 ± 30. 3 days, mean mechanical ventilation day was 11.4 ± 39.1 days, mean urinary tract catheterization day was 12.6 ±33.3 days. During the surveillance period, nosocomial infections occurred in 66 patients, the overall incidence was 19.0% or 20.8 cases per 1000 ICU day. Lung, urinary tract and blood stream were the commonest three sites, which accounts for 62.7 % of nosocomial infection, all of them were device-associated nosocomial infection. The hospital survival rate was 87. 5% in this study. The device utilization ratios for artery/central line catheterization, mechanical ventilation, and urine tract catheterization were 68, 68, and 75 days per hundred ICU stay days respectively. Incidence of catheter-associated blood stream infection, ventilator-associated infection and catheter- associated urinary tract infection were 5. 1‰, 7. 8‰, and 5. 8‰ cases per 1000 ICU stay days. Gram negtive bacteria were still the main pathogenic microorganism, accounting for 68. 8%. Of the isolates, Candida species accounted for 14.3 % of the isolates. CONCLUSIONS Current situation of device associated nosocomial infection in China is better than that in similar ICUs in developing countries, but is not a patch on similar ICUs in the United States. Surveillances for nosocomial infection are need to be enhanced in China. Compliance to infection control protocols in health care staffes is also need to be enhanced.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第12期1692-1694,共3页
Chinese Journal of Nosocomiology
关键词
导管相关性医院感染
器械使用率
重症监护病房
流行病学
Catheter associated nosocomial infection
Device utilization ratio
Intensive care unit
Epidemiology
