综合ICU医院感染的目标监测与分析

Targeted monitoring of nosocomial infections in general ICU

目的对医院综合ICU医院感染的情况进行目标监测,为预防和控制医院感染提供依据。方法对2012年1月-2013年9月医院综合ICU患者的侵入性操作与相关感染情况开展感染目标监测,并对监测的结果进行统计和分析。结果调查的ICU患者例数1 152例,发生医院感染200例,医院感染率17.36%,日感染率为16.59‰,根据病情的严重程度调整后感染的发生率为4.42%;呼吸机相关性肺炎发生率为23.32‰,导尿管相关性尿路感染率为7.18‰,静脉置管相关性血流感染率为5.18‰;感染部位以下呼吸道为主,占48.50%;检测病原菌以革兰阴性杆菌为主,其中铜绿假单胞菌最常见,占19.03%。结论综合性ICU患者的医院感染率较高,与留置各类导管及应用医疗器械而破坏患者正常的生理屏障相关,针对ICU侵入性操作应加强无菌管理和护理干预。

OBJECTIVE To conduct the targeted monitoring of prevalence of nosocomial infections in the general ICU so as to provide reliable basis for prevention and control of the nosocomial infections.METHODS The targeted monitoring was conducted for the prevalence of nosocomial infections in the patients who received the invasive op-erations in the general ICU from Jan 2012 to Sep 2013,and the results of the targeted monitoring were statistically analyzed.RESULTS The nosocomial infections occurred in 200 of 1 152 ICU patients with the incidence rate of 17.36% and the daily infection rate of 16.59‰;the incidence of infections was 4.42% after it was adjusted ac-cording to the severity of illness;the incidence of ventilator-associated pneumonia was 23.32‰;the incidence of catheter-related urinary tract infections was 7.18‰;the incidence of intravenous catheter-related bloodstream in-fections was 5.18‰.The lower respiratory tract was the predominant infection site,accounting for 48.50%.The gram-negative bacilli were dominant among the isolated pathogens,among which the Pseudomonasaeruginosa was the most common species,accounting for 19.03%.CONCLUSION The incidence of nosocomial infections is high in the general ICU patients,which is associated with the catheter indwelling and use of medical instrument as well as the damage of normal physiological barrier;it is necessary to strengthen the aseptic management and take nursing interventions in response to the invasive operations in the ICU.