重症监护病房非导管相关性医院感染的前瞻性研究

A Prospective Study of Non-catheter-related Hospital Infection in Intensive Care Unit

目的分析和探讨非导管相关性感染在重症监护病房(ICU)医院感染中的重要性。方法对2011年1月-2013年12月进入综合ICU的所有患者进行前瞻性目标监测,并将医院感染病例按感染类型进行分组分析。结果共监测5 364例患者,发生医院感染455例(616例次),例次率为11.5%。其中导管相关性感染例次数、构成比均呈逐年下降趋势,而非导管相关性感染例次数和构成比均呈逐年上升趋势。发生医院感染的455例患者中,混合感染组患者住ICU时间>导管相关性感染组>非导管相关性感染组(P<0.05);混合感染组住院时间高于导管相关性感染组和非导管相关性感染组(P<0.05);导管相关性感染组粗死亡率高于非导管相关性感染组和混合感染组(P<0.017)。结论导管相关性感染会延长ICU患者住院时间,增加其死亡风险,仍然是ICU医院感染目标性监测的重点。非导管相关性感染在ICU医院感染中所占比重越来越高,也应予以足够重视。

Objective To analyze and discuss the importance of non-catheter-related hospital infection in intensive care unit（ICU）. Methods A prospective target monitoring of all the patients in the general ICU was carried out from January 2011 to December 2013. The hospital infection cases grouped by infection types were analyzed with SPSS 17.0. Results A total of 5 364 patients were monitored, 455 of whom had hospital infections totaled 616 times. The hospital infection rate was 11.5%. The amount and constituent ratio of the catheter-related infections showed a declining trend year by year, while the non-catheter-related infections revealed an escalating trend year by year. In these 455 patients, the mixed infection group had the longest hospital stay, followed by the catheter-related infection group and the non-catheter-related infection group（P〈0.05）. The catheter-related infection group had higher crude mortality rate than both of the mixed infection group and the non-catheter-related infection group（P〈0.017）. Conclusion Noncatheter-related infections which get higher and higher proportion in ICU hospital infections should be paid more attention to, while catheter-related infections which could prolong hospitalization and increase the risk of death in ICU patients, remain the focus of the target monitoring of hospital infection in ICU.