呼吸内科重症监护病房医院感染目标性监测分析与对策

Analysis and strategies of targeted surveillance for nosocomial infection in ICU ward of pulmonary medicine

目的加强呼吸内科重症监护病房(ICU)医院感染管理,动态了解医院感染发生率及相关导管感染率,针对性采取防控措施。方法确定ICU目标性监测方案,设计医院感染个案监测和ICU日志表格,对2010年1～12月入住呼吸内科ICU患者进行前瞻性调查,对监测结果进行分析、总结,并及时反馈到科室,针对性地进行干预控制。结果共调查706例患者,发生医院感染115例,病例(例次)感染率为16.29%,患者日感染率(例次)为21.20‰。呼吸机相关肺部感染率为13.48‰,中心静脉导管相关血流感染率为0.79‰,尿管相关尿路感染率为0.27‰。医院感染部位以肺部感染为主。结论 ICU目标性监测是一种科学、有效的方法,便于监测ICU医院感染动态变化,并制订有效的感染控制措施。

Objective To strengthen the management in the ICU ward of pulmonary medicine,research dynamically the incidence of nosocomial infection and catheter-related infection,and take corresponding prevention and control measures.Methods Targeted surveillance scheme in ICU was determined,and case surveillance and log tables of nosocomial infection were designed.Patients in ICU ward of pulmonary medicine from January to December 2010 were subjected to prospective study.The surveillance results were analyzed,summarized and fed back timely to clinical departments,and targeted intervention control was carried out.Results A total of 706 patients were included.115 cases of nosocomial infection occurred,with infection rate（case-times） of 16.29% and daily infection rate（case-times） of 21.20‰.It demonstrated ventilator-associated pulmonary infection rate of 13.48‰,central venous catheter-related bloodstream infection rate of 0.79‰,urinary tract-related infection rate of 0.27‰.Nosocomial infection mostly occurred in lung.Conclusion ICU targeted surveillance is a scientific and effective method which can contribute to monitoring the dynamic changes of nosocomial infection in ICU ward and working out effective measures for infection control.