ICU住院患者医院感染病例调查

INVESTIGATION OF NOSOCOMIAL INFECTIONS OF INTENSIVE CARE UNIT PATIENTS

目的了解重症监护病房(ICU)住院患者医院感染的特点及耐药菌情况,指导临床进行有效防控。方法采用回顾性调查方法,对某医院2011年ICU所有住院患者的医院感染及其耐药菌情况进行调查与分析。结果该医院ICU在2011年度共收治260例患者,发生医院感染60例,感染发生率为23%。感染部位以下呼吸道最多见,其次为创面感染。从感染病人标本中共分离出致病菌90株,革兰阴性杆菌占62.22%,其中大肠埃希菌和铜绿假单胞菌居前2位;革兰阳性球菌占30%和真菌占7.78%。大肠埃希菌和铜绿假单胞菌对18种常用抗菌药物全部出现耐药,多数耐药率达到50%以上。结论该医院ICU住院病人医院感染率较高,分离出的革兰阴性杆菌普遍耐药,应采取针对性干预措施,降低感染发生率。

Objective To know the characteristics and drug resistance of nosocomial infections of patients in ICU, so as to guide for clinical medication and prevention. Methods The retrospective survey was used to analyze the characteristics and drug resistance of patients in ICU in the year 2011. Results Among 260 cases of ICU patients investigated, the noso- comial infection occurred in 60 cases with the infection rate of 23. 00%. The main infection site was the lower respiratory tract, and then followed by infection of wound. 90 strains of pathogenic bacteria were isolated. The top two species of Gram -negative bacteria （62. 22% ） were Escherichia coli and Pseudomonas aeruginosa. The Gram -positive bacteria and fungi accounted for 30.00% and 7.78% respectively. The results of drug sensitivity tests showed the isolated strains had the higher drug - resistance, especially Escherichia coli and Pseudomonas aeruginosa. Conclusion The incidence rate of noso- comial infection in ICU patients of the hospital is high. The gram - negative bacteria isolated are commonly drug - resistant. We should strengthen the prevention and control measures so as to reduce nosocomial infections.