重症监护室医院感染及其危险因素研究

Research on nosocomial infection and its risk factors in an intensive care unit

目的调查某院中心重症监护室(ICU)医院感染发生情况及其相关危险因素。方法采用目标性监测方法。对2007年1-12月在中心ICU住院且时间>48 h的所有患者进行调查。结果共监测214例患者,发生医院感染51例,67例次,医院感染率23.83%,感染例次率31.31%。主要感染部位为肺部(71.64%)和泌尿道(11.94%)。分离出病原体217株,其中革兰阴性杆菌116株(53.46%),革兰阳性球菌82株(37.79%),真菌19株(8.76%)。居前4位的病原体是金黄色葡萄球菌(26.73%)、鲍曼不动杆菌(10.60%)、肠球菌属(10.60%)、铜绿假单胞菌(9.68%)。医院感染的危险因素为年龄(≥58岁)、器官功能衰减、使用呼吸机、住ICU时间长。结论 ICU医院感染率高,病原体以革兰阴性菌为主,应针对相关危险因素和常见医院感染进行预防。

Objective To investigate the state and risk factors for nosocomial infection （NI） in a general intensive care unit（ICU） . Methods Patients who were hospitalized in ICU for 〉48 hours between January-December, 2007 were investigated by targeted monitor methods. Results A total of 214 patients were surveyed, 51 patients developed 67 cases of NI, NI rate was 23.83%, NI case rate was 31.31%. The main infection sites were lung （71.64%） and urinary tract （11.94%）. 217 strains of pathogens were isolated, 116（53. 46%） of which were gram negative bacilli, 82（37. 79%） were gram positive cocci, 19（8. 76%） were fungi. The top 4 pathogens were Staphylococcus aureus （26. 73%）, Acinetobacter baurr, annii （10. 06%）, Enterococci spp. （10. 60%）, and Pseudomonas aeruginosa （9. 68%）. The risk factors for NI were age≥58 years old, dysfunctin of organs, use of respirator, long length of staying in ICU. Conclusion NI is high in ICU patients, the major pathogen is gram-negative bacilli, prevention should be carried out according to the related risk factors and commonly occurred NI.