摘要
目的了解重症监护室发生医院感染的相关高危因素、病原菌的分布及耐药情况,制定相应策略,为控制医院感染提供循证依据。方法前瞻性观察420例重症监护病房患者,根据入选和排除标准,遴选符合医院感染病例,留取痰、尿、血液标本,进行细菌培养、真菌培养,阳性者进行药物敏感试验,并分析相关危险因素。结果(1)118例符合标准入选为医院感染病例,发生率为20.1%;(2)高龄、气管插管、应用呼吸机、尿管留置、深静脉置管是发生医院感染的高危因素;(3)培养阳性病原微生物188株,其中呼吸道源性101株(53.73%);(4)以铜绿假单胞(39株)、金黄色葡萄球菌(35株)、肺炎克雷伯菌(34株)和屎肠球菌(18株)居前四位。结论重症监护病房医院感染发生率高(20.1%),应注意危险因素,必须加强病原菌监测及进行有效的医院感染控制,以预防和控制医院感染的发生。
Objective To investigate the distribution of pathogens, drug resistance and related high risk factors of nosocomial infection pathogens in ICU and to make corresponding strategies to provide evidence-based basis for controlling nosocomial infection. Methods 420 patients in ICU were consecutively enrolled prospectively according to selection and exclusion criteria. The samples of sputum, urine and blood were collected to perform bacterial and fungal culture. Drug sensitivity test were taken and related risk factors were analyzed in the samples. Results 118 patients that came up to the criteria had nosocomial infection, the rate of nosocomial infection was 20.1%. The high risk factors of nosocomial infection were advanced age, tracheal intubation, ventilator application, indwelling catheter and deep vein catheterization. 188 strains of positive pathogenic microorganisms were cultured, of which there were 101 respiratory-derived strains （53.73%）. Pseudomonas aeruginosa （39 strains）, staphylococcus aureus （35 strains）, klebsiella pneumonia （34 strains） and enterococcus faecium （ 18 strains） came to the first four places. Conclusion There was a high incidence of nosocomial infection （20.1%） in ICU and more attention should be paid to the related risk factors. The pathogens monitoring should be strengthened and nosecomial infection should be controlled effectively by preventing.
出处
《中国病案》
2012年第12期61-63,共3页
Chinese Medical Record
关键词
重症监护病房
院内感染
病原体
耐药
高危因素
Intensive care unit
Nosocomial infection
Pathogen
Drug resistance
High risk factor
