重症监护病房医院感染流行病学调查及预防

EPIDEMIOLOGICAL INVESTIGATION OF NOSOCOMIAL INFECTION IN INTENSIVE CARE UNIT.

目的：探讨重症监护病房（ICU）医院感染流行病学的特征和相关因素，为预防控制医院感染提供依据，方法：对2002年1月～2004年12月收治的319例ICU患者进行医院感染回顾性调查。结果：ICU医院感染发生率17，24％，常见感染部位前5位的是下呼吸道感染50．9l％、上呼吸道感染20．00％、泌尿道感染9．09r‰、胃肠遭感染7．27％、血液感染5，45％；分离出病原菌29株，革兰阴性菌占62．07％；居前3位的是假单胞菌31．03％、金黄色葡萄球菌20．69％、不动杆菌17，24％；医院感染的危险因素是使用呼吸机、泌尿道插管、动静脉插管、留ICU时间长。结论：ICU医院感染发生率高；病原菌以革兰阴性菌为主；应针对相关危险因索和常见医院感染进行预防。

Objective： To investigate the prevalence and risk factors of nosocomial infection （NI） in Intensive Care Unit （ICU）. Methods： A retrospective study was carried out to investigate the NI in ICU during the period from January, 2002 to Decemember, 2004. Results： The overall incidence of NI was 17.24% （55/319）, the common 5 types of NI were lower respiratory tract infection （50.91% ）, upper respiratory tract infection （20.00%）, urinary tract infection （9.09%）, gastrointes- timal infection （7.27%） and blood infection （5.45%）. 29 strains were isolated among which the Gram- negative bacteria was 62.07% （18/29）. The leading causative microorganisms were Pseudomonas （31.03 % ）, Staphylococcus aureus （20.69 % ）, Acinetobacter （17.24%） ; The risk factors for NI were as follows： respiratory ventilator, indwelling catheter, blood catheter and long ICU stay. Conclusion： The incidence rate of NI was high in ICU; The leading causative microorganisms were Gram- negative bacteria; The measures should be adopted to prevent and control N1 according to the risk factors and the common types of N1.