综合ICU医院感染的调查及预防策略

Prevalence of nosocomial infections in a general ICU and prevention strategies

目的分析医院综合ICU医院感染现状,为有效预防与控制医院感染提供依据。方法采用前瞻性和回顾性调查相结合的方法,对2005-2011年入住综合ICU的3646例患者临床资料进行总结分析。结果 3646例住院患者发生医院感染606例、657例次,感染率为16.62%、例次感染率为18.02%;感染部位以下呼吸道为主占64.08%,其次是泌尿道占21.46%;检出病原菌613株,革兰阴性菌占60.52%,革兰阳性菌占27.08%,真菌占12.40%。结论 ICU医院感染率高,主要与侵入性操作相关;感染病原菌为医院常见的耐药菌,因此ICU仍然是医院感染关注的重点,持续监测及时准确获得ICU医院感染动态变化,制定有效干预措施,降低医院感染发生率。

OBJECTIVE To understand the current status of nosocomial infections in a comprehensive ICU so as to provide evidence for prevention and control of nosocomial infections. METHODS The clinical data of 3646 cases of comprehensive ICU from 2005 to 2011 were analyzed by prospective survey combined with retrospective survey. RESULTS Of 3646 cases of hospitalized patients, the nosocomial infections occurred in 606 cases （657 case-times） of patients with the infection rate of 16.62% and the case-time infection rate of 18.02%. The lower respiratory tract was the main infections site, accounting for 64.08%, followed by the urinary tract （21.46%）. Of totally 613 strains of pathogens isolated, the gram-negative bacteria accounted for 60. 52%, the gram-positive bacteria 27.08%, and fungi 12.40%. CONCLUSION The incidence of the nosocomial infections is high in the ICU, which is mainly related to the invasive operations ; the pathogens are the common drug resistant strains. The ICU is still the focus of prevention and control of nosocomial infections. Dynamic information of nosocomial infections can be acquired accurately in time through continuous monitoring, and the effective intervention measures can be drawn up to reduce the incidence of nosocomial infections.