NICU不同季节室内病原菌监测分析

Surveillance of pathogens in NICU in different seasons

目的分析神经内科重症监护病房(NICU)空气环境的微生物学分布特征,为医院感染控制提供依据。方法 2010年9月-2011年9月对NICU的大(6人间)、小病房(2人间)采用密闭式空气净化器进行空气消毒,每日上、下午对大、小病房空气环境微生物的分布特征、病原菌检出率进行比较。结果在大病房中各月份空气环境平均菌落数高于小病房相应各个月份空气环境平均菌落数,大房间中,秋季空气菌落数量最多,最多时达到233CFU/m3,差异有统计学意义(P<0.05);2010年患者医院感染率,透析室为41.6%、血管通路为12.4%、呼吸道为25.1%、其他感染为11.3%,2011年患者医院感染率,透析室为38.3%、血管通路为10.5%、呼吸道为22.2%、其他感染为8.1%,采取密闭消毒后NICU医院感染的发生率自2010年后显著下降,患者发生下呼吸道感染及其他类感染逐年降低,差异有统计学意义(P<0.05)。结论 NICU空气中细菌数量受患者数量的影响,以革兰阳性菌为主,也有少量革兰阴性菌和真菌等致病菌,于NICU实行密闭式空气消毒可以全面降低细菌总量和医院感染率,提高NICU环境安全。

OBJECTIVE To analyze the microbiological characteristics of air in the neurological intensive care unit （NICU） so as to provide guidance for control of nosocoraial infections. METHODS From Sep 2010 to Sep 2011, totally 6 big wards and 2 small wards of the NICU were disinfected By using closed air purifier, then the characteristics of distribution of microorganism in the air of big and small wards and the detection rate of pathogens were ob- served and compared in the morning and after noon for each day. RESULTS The average bacterial colony counts in the air were higher each month in the big wards than in the small wards; in the big wards, the bacterial colony Counts reached the highest in autumn （233 CFU/ma）, the difference was significant （P〈0.05）. In 2010, the incidence of nosocomial infections was 41, 6% in the dialysis room, the incidence of vascular access infections was 12. 4%, the incidence of respiratory tract infections was 25.1%, the incidence of other infections Was 11.3%. In 2011, the incidence of nosocomial infections was 38.3% in the dialysis room, the incidence of vascular access infections was 10.5%, the incidence of respiratory tract infections was 22. 2%, and the incidence of other infections was 8. 1%. CONCLUSION The bacterial colony counts in the air of NICU are influenced by the number of patients; the gram-positive bacteria are the predominant bacteria, and the pathogenic bacteria also consists of the gram-negative bacteria and fungi. The implementation of closed air disinfection can comprehensively reduce the total bacterial colony counts and the incidence of nosoeomial in{eetions and improve the environmental safety in NICU.