ICU导尿管相关性尿路感染发生因素与病原学分析

Risk factors and etiology of catheter-related urinary tract infections in patients in ICU

目的探讨医院ICU导尿管相关性尿路感染(CAUTIs)发生因素与病原学分析。方法采用回顾性调查分析医院2008、2009年ICU 87例导尿管相关性尿路感染病例。结果革兰阴性病原菌占35.9%,以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌为主,分别为11.7%、7.6%、5.5%,革兰阳性菌占24.1%,以粪肠球菌、屎肠球菌、鹑鸡肠球菌为主,分别为4.1%、11.7%、5.5%,真菌占40.0%,以假丝酵母菌属为主;87例患者中,混合性感染36例;各种严重的基础疾病、意识障碍、长时间留置导尿、高效广谱抗菌药物长期或不合理应用、女性、老年均是ICU CAUTIs的主要因素。结论 ICU CAUTIs发生与多种因素有关,缩短导尿管留置时间是降低CAUTIs发生率直接措施。

OBJECTIVE To study the risk factors and etiology of urinary catheter related infection of patients in our ICU.METHODS The clinical data of patients with catheter-associated urinary tract infections（CAUTIs） in our department were analyzed retrospectively from 2008 to 2009.RESULTS In ICU,the main risk factors of CAUTIs included severe basic diseases,unconsciousness,indwelling time,the broad spectrum antibiotics use,gender,age and so on.The main Gram-negative bacteria（35.9%）were Escherichia coli（11.7%）,Pseudomonas aeruginosa（7.6%）,Klebsiella pneumoniae（5.5%）,while the main Gram-positive bacteria（24.1%）included Enterococcus faecalis（24.1%）,E.faecium（24.1%）,E.gallinarum（24.1%）,the main fungi was candida（40.0%）.Among the 87 cases,36 cases were mixed-infection.CONCLUSION CAUTIs are mostly occurred in ICU,which are associated with many factors,to shorten the time for detaining the catheter is the direct measure to reduce the incidence of CAUTIs.