急诊重症监护病房医院感染危险因素与干预措施

Intervention Strategy of Risk Factors of Nosocomial Infection in Patients in Emergency Intensive Care Unit

目的调查急诊重症监护病房(EICU)医院感染的现状和危险因素,以制定干预对策。方法采用前瞻性监测和回顾性调查相结合的方法,对72例医院感染病例进行统计分析。结果EICU患者医院感染率为29.50%,显著高于同期医院平均感染率5.25%;发生医院感染的病例中≥60岁老年患者感染率高达61.11%;平均住院日为28d;医院感染部位的分布以下呼吸道感染为主,医院感染的病原菌以革兰阴性杆菌为主。结论EICU是医院感染的高发科室,其收治的患者基础疾病严重、侵入性诊疗操作多、大量使用抗菌药物、老年患者免疫功能低下等均是造成医院内感染的危险因素,应采取综合性干预对策,以切实降低感染率,提高抢救成功率。

OBJECTIVE The status and risk factors of nosocomial infection（NI） in patients in emergency intensive care units were invrstigated to make the intervention strategy. METHODS The prospective monitoring and retrospective investigation were used analyze the 72 nosocomial infection patients in EICU. RESULTS Incidence rate of NI in patients in EICU was 29.50%. It was significantly higher than average incidence rate of NI of the whole hospital at the same time; ≥60-year-old of rate of NI in patients was 60.52% ; The average hospitalization days were 28 days; The lower respiratory tract was the most common infection site. The most common infection microorganism in EICU was Gram-negative bacteria. CONCLUSIONS The incidence rate of EICU is much higher than that in other departments. The invasive procedure, the quality of disinfection and sterilization, and patients immunity status especially in the old. were the risk factors General intervention strategy should be adopted in the control of EICU nosocomial infection to reduce the infection rate and raise the rescue rate.