RICU医院感染的管理及预防

Control and prevention of nosocomial infections in RICU

目的研究医院呼吸科重症监护病房(RICU)的管理情况,为预防RICU医院感染提供指导。方法以医院呼吸科2010年1月-2012年2月40例RICU医院感染的住院患者为研究对象,分析患者的感染原因、下呼吸道的病原菌分布及耐药性。结果铜绿假单胞菌及鲍氏不动杆菌为主要病原菌,患者感染率高达100.0%,葡萄球菌属、大肠埃希菌、肺炎克雷伯菌、嗜麦芽寡养单胞菌、肠球菌属患者感染率分别为7.5%、7.5%、42.5%、50.0%、12.5%;患者主要为革兰阴性菌感染,鲍氏不动杆菌对抗菌药物呈多药耐药,铜绿假单胞菌对抗菌药物均表现不同水平耐药;40例重症呼吸监护患者有13例死亡。结论完善ICU制度管理,加强对患者预防隔离及医务人员的无菌操作观念,合理用药,对减少RICU医院感染有重要意义。

OBJECTIVE To study the management of respiratory intensive care unit（RICU）so as to provide basis for the prevention of nosocomial infections in the RICU. METHODS The clinical data of 40 patients with nosocomial infections who were admitted to the RICU from Jan 2010 to Feb 2012 were retrospectively analyzed. The causes of the infection, the distribution of bacteria in lower respiratory tract, and the drug resistance were analyzed respectively. RESULTS Acinetobacter baumannii and Paeudomonas aeruginosa were the most prevalent species of pathogens,and the prevalence rate of infections was 100.0%; the prevalence rate of Staphylococci infections was 7.5%, Escherichia coli infections 7. 5%, Klebsiella pneumoniae infections 42. 5%, Stenotrophomonas maltophilia infections 50.0 %, and Enterococci infections 12.5 %. The gram-negative bacteria were the main pathogens causing the infections, Acinetobacter baumannii was multidrug resistant, and Pseudomonas aeruginosa varied in the drug resistance to different antibiotics. CONCLUSION It is of great significance in reducing the incidence of nosocomial infections in the RICU to perfect the ICU system management, to strengthen the isolation of patients as well as the aseptic operation concept and to reasonably use antibiotics.