ICU医院感染目标性监测分析

Targeted monitoring of nosocomial infections in intensive care unit

目的分析重症监护病房(ICU)医院感染的发生率及危险因素,探讨预防措施,减少ICU医院感染的发生。方法采取目标性监测方法,对2008年9月-2009年3月ICU收治的1262例患者发生医院感染情况进行调查。结果 1262例患者中发生医院感染92例次,例次感染率为7.29%,日感染率为39.4‰,日感染率调整率为11.29‰;感染部位以肺部为主,占67.39%;分离的病原菌主要为金黄色葡萄球菌、铜绿假单胞菌及肺炎克雷伯菌,分别占20.76%、15.23%及12.46%。结论 ICU医院感染以肺部为主,病原菌以金黄色葡萄球菌为主;应加强病区消毒隔离制度,严格无菌技术操作,加强气道管理,合理应用抗菌药物,为患者提供营养支持,从而有效减少医院感染的发生。

OBJECTIVE To analyze the incidence and the related factors for nosocomial infections in ICU in order to explore preventive measures to reduce nosocomial infections. METHODS A total of 1262 patients with nosocomial infections who enrolled in ICU from Sep 2008 to Mar 2009 were investigated by adopting targeted surveillance. RESULTS Of 1262 patients investigated, 92 cases occurred with hospital infections, with the infection rate of 7.29% and daily infection rate of 39.4%, the adjusting rate of daily infection rate was 11.29‰ the lung was the predominant site with infection, accounting for 67.39% ; Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the main isolated pathogens, accounting for 20. 76%, 15. 23%, and 12. 46%, respectively. CONCLUSION Lung is the major site with infections in ICU, S. aureus is the dominant pathogen; so it is necessary to strengthen the disinfection and isolation system in ICU, implement aseptic operation strictly, enhance the management of airway, use antibiotics reasonably, and provide the patients with supportive nutrition so as to reduce nosocomial infections.