NICU医院感染目标性监测分析

Targeted surveillance of nosocomial infections in neurological intensive care unit

目的调查神经内科重症监护病房(NICU)医院感染发生情况。方法对首都医科大学附属北京朝阳医院NICU的216例患者临床资料进行目标性监测,分析器械使用率及相关感染率,并与国际数据加以对比。结果NICU患者的例次感染率为21.76%,以呼吸道感染为主,占76.60%,根据平均病情严重程度调整后的患者日感染率为4.30‰;呼吸机、留置尿管和中心静脉导管的使用率分别为15.12%、80.40%和33.81%,而相关肺部感染、泌尿道感染和血流感染的发病率分别为23.44‰、2.20‰和0。结论 NICU有其特有的危险因素,感染率较高,尤其是呼吸机相关性肺部感染率远高于国外水平,应有针对性的加强干预措施。

OBJECTIVE To investigate the occurrence characters of nosocomial infection in neurological intensive care unit（NICU）. METHODS The clinical data of 216 patients in NICU of Beijing Chaoyang Hospital Affiliated to Capital Medical University were studied using targeted surveillance.Meanwhile,the device utilization ratios and device-associated infection ratios were analyzed and compared with the international data. RESULTS The nosocomial infection ratio of NICU patients was 21.76%,and the daily nosocomial infection rate was 4.30‰ after adjusting with ASIS method.Main sites of the infection was respiratory tract infection（76.60%）.The utilization ratios of ventilator,urinary catheter and central line were 15.12%,80.40% and 33.81%,respectively.The associated pneumonia rate,urinary tract infection rate and bloodstream infection rate were 23.44‰,2.20‰ and 0,respectively. CONCLUSIONS Due to the unique risk factors,NICU has a higher nosocomial infection rate,especially ventilator-associated pneumonia rate,which is higher than the international levels.Targeted interventions should be enforced to reduce the device-associated infection rates.