摘要
目的了解ICU患者医院感染发生率及危险因素,为制定医院感染预防控制措施提供科学依据。方法按照卫生部制定的《医院感染监测规范》中有关医院感染目标性监测的方法对医院2011年1-12月ICU住院患者进行监测。结果 217例ICU住院时间>48h的患者中发生医院感染31例,感染率为14.29%,日感染率为0.40%;感染部位以下呼吸道为主,占51.61%,其次为血液、泌尿道,分别占32.26%、9.68%;侵入性操作相关感染以呼吸机相关性感染居首位,感染率为9.94%;中心静脉置管和留置尿管相关性感染次之,感染率分布为6.10%和1.85%;医院感染患者送检标本4014份,培养阳性菌株3053株,阳性率为76.06%,其中革兰阴性菌2299株占75.30%,革兰阳性菌627株占20.54%,真菌127株占4.16%,排名前3位病原菌依次为铜绿假单胞菌、鲍氏不动杆菌、金黄色葡萄球菌,分别占34.03%、22.76%、16.41%。结论 ICU患者是医院感染高发人群,医院感染以3种导管留置患者为主,目标性监测可针对3种侵入性诊疗操作实施全程管理,重点干预诊疗操作中的医疗行为,对预防控制ICU患者留置导尿管、中心静脉插管、呼吸机使用的感染发病率具有显著效果,因此,目标性监测是减少医院感染的科学监测方法。
OBJECTIVE To understand the incidence and risk factors of nosocomial infections in intensive care unit （ICU） and provide the scientific basis for developing the prevention and control measures of nosocomial infections. METHODS According to the targeted monitoring method in ＂Specification for monitoring of hospital infection＇, the patients who hospitalized in the ICU from Jan to Dec, 2011 were monitored. RESULTS Of totally 217 patients who hospitalized in the ICU for more than 48 hours, the nosocomial infections occurred in 31 cases with the infection rate of 14.29% and the daily infection rate of 0.40%. The lower respiratory tract was the predominant infection site, accounting for 51.61%, followed by the blood （32.26%） and the urinary tract （9. 68%）. Among the cases with invasive operation-related infections, the patients with ventilator-associated infections ranked the first place （9.94%）, followed by the patients with central venous catheter-related infections （6.10%） and the patients with indwelling catheter-related infections （1. 85%）. Of totally 4014 submitted specimens from the patients with nosocomial infections, there were 3053 cultured positive with the positive rate of 76. 06%, including 2299 （75.30%） strains of gram-negative bacteria, 627 （20.54%） strains of gram-positive bacteria, and 127 （4.16%） strains of fungi; the Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus, ranked the top three species of pathogens, accounting for 34.03%, 22.76 %, and 16.41 %, respectively. CONCLUSION The patients in ICU are the populations at high risk of nosocomial infections, and the three types of indwelling catheter- related infections are dominant. The targeted monitoring can make the whole process management implemented aimed at the three types of invasive operations, focusing on the medical behavior in the interventional operation, which can achieve significant effect on the control of indwelling catheter-related infections, central venous catheter- related infections, or the ventilator-associated infections in the ICU patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2299-2301,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
医院感染
目标性监测
病原菌
Intensive care unit
Nosocomial infection
Targeted monitoring
Pathogen
