2007-2009年ICU医院感染调查与分析

Nosocomial infections in intensive care unit during 2007-2009:a retrospective investigation and analysis

目的了解ICU内医院获得性感染的流行病学规律、病原菌、医院感染类型和分布,探讨其易感因素指导临床防治,合理使用抗菌药物,降低细菌耐药性的产生。方法对ICU 2007年1月-2009年12月7738例住院患者进行回顾性调查,有427例患者符合医院获得性感染的标准。结果医院获得性感染的平均感染率为5.52%,呼吸道感染位居首位,占72.13%;常见病原菌有鲍氏不动杆菌、金黄色葡萄球菌、铜绿假单胞菌和肺炎克雷伯菌,革兰阴性菌居首位,革兰阳性菌有上升趋势。结论 ICU内医院感染的患病率仍居高不下,ICU医院感染部位仍以呼吸道为主,应加强空气传播的防护建立相应的监控制度,掌握病原菌变化规律,更有效地预防和治疗ICU内获得性感染。

OBJECTIVE To study the prevalence of nosocomial infection,the distribution of pathogens and the types of nosocomial infection in ICU,so as to offer evidence for clinical diagnosis and treatment and the rational use of antibiotics in ICU and reduce bacterial resistance.METHODS The medical record of 7738 cases in ICU were retrospectively analyzed during Jan 2007-Dec 2009,among which,427 cases of patients were consistent with diagnostic criteria of NI.RESULTS The average prevalence rate of NI was 5.52% during 2007-2009.The major infected site was respiratory tract（72.13%）,The most common pathogens of NI were Acinbactoter baumanii,Staphylococcus aureus,Pseudomonas aeruginosa and Klebsiella pneumoniae.CONCLUSION The prevalence rate of nosocomial infection in the intensive care unit still keep a high level.The major infected sites of NI in ICU is respiratory tract,to ward which the prevention of air spreading should be strengthened.So it is important to establish NI monitor system and grasp the rule of the changes of pathogens so as to effectively prevent the nosocomial infection in ICU.