ICU医院感染细菌学特点及相关因素分析

Bacteriological analysis of characteristics and related factors of nosocomial infection in ICU

①目的观察ICU患者医院感染细菌特点及其相关影响因素。②方法回顾性分析ICU病房2 372例住院患者的资料。③结果 2 372例患者共发生感染114例,医院感染发生率为4.81%。感染部位分布以呼吸道感染最多,占39.47%,其次为泌尿道和血液,分别占19.30%和14.04%。114例患者中共分离出130株病原菌,其中分离出单一病原菌98例,占85.96%;分离出2种病原菌10例,占8.77%;分离出3种病原菌6例,占5.26%。130株病原菌中革兰阴性菌89株,占68.46%;革兰阳性菌29株,占22.31%;真菌12株,占9.23%;分布前3位的致病菌为铜绿假单胞菌、金黄色葡萄球菌和肺炎克雷伯菌,分别占29.23%、18.46%和16.15%。单因素χ2检验分析,医院感染发生的高危因素为高龄、侵袭性操作、较长时间入住ICU和使用激素(P<0.05)。④结论 ICU医院感染发生率高,并且感染情况复杂,应加强ICU医院感染的监测工作,降低医院感染的发生率。

Objective To observe ICU patients hospital infection bacteria characteristics and related factors. Methods Retrospective analysis 2372 cases of hospitalized patients with material in the ICU ward.Results There were 114 infected cases in 2372 patients,for nosocomial infection 4. 81%. With infected site distribution,accounting for most 39. 47% respiratory infection,secondly urinary tract and blood,19. 30% and14. 04% respectively. 114 patients separate out 130 strains pathogens,including 13 strains isolated single pathogen 98 cases,accounting for 85. 96%,separating out two pathogens of 10 cases,8. 77%,separating out three kinds of pathogens in 6 cases,5. 26%. There are 89 strains Gram-negative bacterium in 130,accounted for 68. 46%,29 strains gram-positie bacterium,accounted for 22. 31%,12 strains fungi,accounted for9. 23%;For the first three pathogenic bacteria distribution of pseudomonas aeruginosa,staphylococcus aureus and Klebsiella pneumoniae,accounted for 29. 23%,18. 46% and 16. 15%,Single factor χ2test analysis,hospital infection risk factors for senior citizens,invasive operation,a relatively long time ICU admission and use hormone（ P〈0. 05）. Conclusion The ICU is high nosocomial infections,and the infection situation complex,should strengthen the monitoring of nosocomial infection in the ICU,reduce the incidence of nosocomial infection.