重症监护病房患者医院感染前瞻性目标监测分析

ICU patients with nosoeomial infection in the forward-looking goal of monitoring and analysis

目的了解本地区ICU医院感染发生情况，为制定防控措施提供依据。方法随机抽出3家医院ICU作为样本进行持续1年的医院感染前瞻性目标监测。结果监测686例ICU住院病人，医院感染率26．09％，例次感染率33．09％；主要感染部位前5位是下呼吸道感染65．36％，泌尿道感染11．73％，胃肠道感染7．26％，血管相关性感染6．15％，皮肤感染3．91％；感染病原体前4位是鲍曼氏不动杆菌23．68％，肺炎克雷伯氏菌19．74％，铜绿假单胞菌15．79％，大肠埃希菌15．79％；4位病原体对头孢类抗生素普遍耐药；有创操作的医院感染率明显增高。结论ICU医院感染前瞻性目标监测值高于回顾性调查值，病原体仍以革兰阴性菌为主，建立人工气道是下呼吸道感染的主要因素，加强人工气道管理、多设单间病房、合理使用抗菌素是降低ICU医院感染的主要措施。

Objective To understand the occurrence of nosocomial infection in ICU, in this region and provide prevention and control measures, as a basis. Met.hock Random samples from three ICU apartmens of hospital to aperate as a continuous one-year forward-looking goal of hospital infection surveillance. Results From monitoring 686 cases of ICU patients, the hospital infection rate of 26.09%, 33.09% cases of second infection; and the main site of infection locating the former 5 are the lower respiratory tract infections65.36%; urinary tract infection 11.73%; gastrointestinal tract infection, 7.26%, vascular-related sexualinfections skin infections6.15%, skin infections 3.91%; on the other hand ,the infected with pathogens, the former 4 are Acinetobacter baumannii＇s 23.68%, 19.74% Klebsiella pneumoniae, Pseudomonas aeruginosa 15.79%, 15.79% Escherichia coli; 4 pathogens to the general resistance to cephalosporins; invasive operation of the hospital infection rate with higher significanty. Conclusions ICU nosocomial infection is higher than the value of the forward-looking goal of monitoring the retrospective survey values, pathogens, Gram-negative bacteria is still mainly the establishment of artificial airway is a major factor in lower respiratory tract infection, strengthen artificial airway management, multi-ward set up a single, rational the use of antibiotics is reduce the ICU nosocomial infection of the major initiatives.