精神病专科医院重症医学科医院感染目标监测分析

Targeted Monitoring Analysis of Nosocomial Infections in ICUs of Psychiatric Hospital

目的分析某精神病专科医院重症医学科(ICU)医院感染目标监测数据,为制订有效措施提供理论依据,以减低医院感染发生率。方法采用前瞻性与回顾性研究相结合的方法,选取某精神病专科医院2013年1月-2014年12月收治的361例患者作为目标监测对象,并对引起感染的危险因素采用SPSS 16.0系统软件进行分析。结果 361例患者发生医院感染36例,感染率为10.0%,日感染率8.9‰。单因素分析显示,年龄≥70岁、住院时间≥14 d、科室转入患者、侵入性操作等是医院感染的危险因素。最常见感染部位以下呼吸道居多,占51.2%;其次为泌尿道、血液感染,分别占30.2%、14.0%。分离出189株病原菌,以革兰氏阴性杆菌为主,占60.3%;其次为革兰氏阳性球菌,占27.5%;第3为真菌,占12.2%。结论某精神病专科医院ICU医院感染发生率较高,根据感染特点,应选择有针对性的干预措施,以降低感染发生率。

Objective To analyze the data of targeted monitoring analysis of nosocomial infections in ICUs in a psychiatric hospital and to put forward intervention measures, so as to reduce the infection rate in hospital. Methods： By means of prospective and retrospective survey, the targeted monitoring analysis of incidence of nosocomial infections was performed for the patients who were hospitalized from Jan 2013 to Dec 2014, then the related factors of nosocomial infection was analyzed. Results： Among 361 hospitalized patients in ICU of a psychiatric hospital, 36 cases suffered the nosocomial infections with the infection rate of 10.0% in total and 8.9%0 in a day. The univariate analysis indicated that the risk factors of nosocomial infections were as follows： patients more than 70 years old, stay in hospital more than 14 days, transferred from other departments, and with invasive operations. The rate of lower respiratory tract infections accounted for 51.2% ,urinary tract infections for 30.2%, blood infections for 14.0%. Of the 189 strains of pathogens isolated from the samples, Gram negative bacilli ranked the first place, accounting for 60.3%, the second was Gram positive cocci （27.5%）, and the third was Fungi （12.2%）. Conclusion： The nosocomial infection rate is high in ICU of a psychiatric hospital. Some measures have to be taken to reduce the incidence of infection.