摘要
目的初步了解徐州地区导尿管相关尿路感染的发病率和病原菌特点,为感染预防控制提供科学依据。方法采用目标性监测方法对徐州地区2015年1月1日-12月31日23所医院入住ICU>48h患者进行监测,收集数据,运用MINKE医院感染管理软件系统对监测资料进行汇总分析,统计出导尿管使用率、导尿管相关尿路感染发病率以及病原菌特点。结果研究期间共监测11581例ICU患者,同期住院总日数49874d,导尿管总日数43777d,导尿管使用率87.78%,其中CAUTI患者45例,CAUTI发病率1.03‰;从住院患者送检标本中检出的病原菌共59株,以革兰阴性菌多见,居前5位的为大肠埃希菌、白念珠菌、屎肠球菌、铜绿假单胞菌、肺炎克雷伯菌;根据Spearman法分析可知,随着留置尿管时间的延长,导尿管相关感染率成正相关增长。结论徐州地区ICU住院患者导尿管的使用率较高,CAUTI发病率低于国内报道,和NHSN数据接近,病原学标本送检率低,检出病原菌以革兰阴性菌为主;需加强影响因素监测,从结果监测过渡到过程监测,监测各项措施的执行。
OBJECTIVE To learn the incidence and characteristics of pathogenic bacteria of catheter-associated urinary tract infections（CAUTI）in Xuzhou,so as to provide scientific basis for prevention and control of infection.METHODS Target surveillance was used for each ICU patient who stayed more than 48 hin ICU from Jan.1st to Dec.31 st,2015 in Xuzhou,and the data were collected.MINKE was employed to sum up and analyze the surveillance data,calculate urinary catheter utilization rates,incidence of CAUTIand the characteristics of pathogenic microorganisms.RESULTS There were a total of 11581 hospitalized patients in the ICU in 2015,with ICU bed days of 49874 dand total urethral catheter day of 43777 d,and the urinary catheter utilization rate was 87.78% .The CAUTI occurred in 45 cases,and the incidence of CAUTI was 1.03‰ .Totally 59 pathogens were detected from inpatient specimens submitted for examination.The gram-negative bacteria were the most common pathogens causing CAUTI in ICU,and the top 5 were Escherichia coli,Candida albicans,Enterococcus faecium,Pseudomonas aeruginosaand Klebsiella pneumoniae.According to the analysis by Spearman method,along with the extension of indwelling time,the infection rate increased gradually with a positive correlation.CONCLUSIONUrinary catheter is widely used in ICU inpatients in Xuzhou.The incidence of CAUTI is lower than that of domestic data and similar with NHSN data.Pathogenic microorganism inspection rate is low,and gram-negative bacteria are the main pathogens.All kinds of infection prevention measures should be included in the monitoring objectives.The transition from result monitoring to process monitoring should be strengthened and the measures should be implemented.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第18期4151-4153,4170,共4页
Chinese Journal of Nosocomiology
基金
江苏省卫生计生委预防医学科研基金资助项目(Y2015067)
关键词
重症监护病房
目标性监测
医院感染
导尿管相关尿路感染
Intensive care unit
Targeted surveillance
Healthcare-associated infection
Catheter-associated urinary tract infection
