北京市三级医院ICU医院感染目标性监测分析

Study on targeted surveillance of nosocomial infections in ICU of tertiary care hospitals in Beijing

目的了解北京市三级医院重症监护病房(ICU),侵入性操作相关医院感染目标性监测开展情况及相关防控措施落实情况。方法制定统一调查表,对北京市38所三级医院的ICU进行现场评估。结果 38所三级医院中有36所开展了侵入性操作相关医院感染目标性监测;36所医院均开展了中心静脉导管相关血流感染(CRB-SI)监测,平均千日导管感染率为2.5‰;26所开展了导尿管相关泌尿系感染(CAUTI)监测,平均千日导管感染率为2.1‰,88.5%的医院对留置尿管患者不再常规进行膀胱冲洗;28所开展了呼吸机相关性肺炎(VAP)监测,平均千日导管感染率为7.6‰,71.5%的医院对气管插管患者口腔护理的次数为2次/d,53.6%的医院使用洗必泰漱口液进行口腔护理。结论绝大多数三级医院已开展医院感染的目标性监测,侵入性操作相关感染防控措施的规范与落实有待进一步推进。

OBJECTIVE To investigate the current status of targeted surveillance for invasive procedure-associated infections and the fulfillment of preventive measures in ICU of tertiary care hospitals in Beijing.METHODS The generic evaluation forms were designed,the investigators were trained,38 Beijing′s tertiary care hospitals′ ICU were evaluated on-site.RESULTS Of 38 tertiary care hospitals,36 hospitals carried out targeted surveillance for invasive operation-associated infections;all of the 36 hospitals had developed the surveillance for central venous catheter-related bloodstream infections（CRBSI） with the catheter infection rate of 2.5 per 1000 patient-days;26 hospitals had developed the surveillance for catheter-associated urinary tract infections（CAUTI） with the catheter infection rate of 2.1 per 1000 patient-days,88.5% of the hospitals no longer executed the routine bladder irrigation;28 hospitals had developed the surveillance for ventilator-associated pneumonia with the catheter infection rate of 7.6 per 1000 patient-days,71.5% of the hospitals carried out oral nursing twice a day for the catheterization patients,and 53.6% of the hospitals conducted oral nursing with chlorhexidine as collutory.CONCLUSION Most of the tertiary care hospitals have carried out the targeted surveillance.Preventive measures about invasive procedure-associated infections should be further standardized.