ICU导管相关性感染及危险因素分析

Catheter-related Infections and Risk Factors in Intensive Care Unit

目的探讨ICU住院患者导管相关性感染(CRI)的病原学特征以及可能的影响因素。方法对2008年1月-2009年6月医院综合ICU住院的268例患者进行观察,统计和分析这时期ICU患者的CRI发生率、病原学特征以及可能相关危险因素。结果共收集深静脉留置管、气管插管、导尿管、胸腔引流管、腹腔引流管等556根,导管检出病原菌阳性率为38.12%,CRI发生率为34.70%,每日每1000根导管发生CRI19.3次;CRI主要病原菌依次为革兰阳性球菌(50.50%)、革兰阴性杆菌(30.30%)和真菌(19.20%);非条件Logistic回归分析提示,重复置管、股静脉置管、使用多腔导管、长期留置导管和长期使用抗菌药物为CRI独立危险因素。结论 ICU住院患者CRI的主要病原菌为革兰阳性球菌;应加强控制CRI危险因素,预防医院感染的发生。

OBJECTIVE To investigate the profiles including the incidence, bacteria spectrum, drug sensitivity and risk factors of cathether-related infections in intensive care unit. METHODS A total of 268 patients with deep vein catheter, tracheal tube, urethral catheter, intrathoracic drain, abdominal cavity drain in intensive care unit from Jan 2008 to Jun 2009 were enrolled in the study. The data of the incidence, pathogens and risk factors of CRI were analyzed. RESULTS The general positive rate of pathogens in all catheters was 38.12%. The incidence of CRI was 34.70%, with an incidence of 19. 3 episodes per 1000 catheter-days. The pathogens causing CRI were mainly Gram positive cocci（50. 50%）, Gram negative bacilli（30.30%）and fungi （19. 20%）. Logistic regression analysis indicated that multiple catheterization, femoral vein catheterization, the application of multicavity catheter, duration of catheterization and long term antibiotic therapy were the independent risk factors for CRI. CONCLUSION The major pathogens causing CRI are Gram positive cocci. The control of risk factors for catheterrelated infections should be strengthened to prevent the occurrence of nosocomial infection.