我院重症监护病房医院感染目标性监测分析

Hospital infection targeted surveillance in intensive care unit of our hospital

目的 了解南京医科大学附属无锡市人民医院（以下简称“我院”）综合重症监护病房（ICU）患者医院感染的现状及特点。方法 采用目标性监测的方法,对我院综合ICU病房2013年1月-2015年12月所有住院患者医院感染的监测数据进行分析。结果 我院综合ICU住院患者共3523例,住院日为31 473 d,发生医院感染374例,416例次,感染率为10.62%,感染例次率为11.81%,日感染率为11.88‰,3年感染率逐年降低;呼吸机、中心静脉导管以及导尿管的使用率分别为44.48%、49.83%及73.35%;呼吸机相关性肺炎、中心静脉相关性血行感染及尿管相关泌尿道感染的发生率分别为10.64‰、2.55‰及2.43‰,且感染率逐年降低;3种器械相关感染所涉及的主要病原菌为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌等。结论 我院综合ICU患者医院感染率与江苏省相似,但明显高于全国水平。针对医院感染危险因素和存在问题进行干预,并采取积极有效的预防措施,持续优化改进措施,可控制和减少ICU医院感染的发生。

Objective To understand the situation and characteristic of hospital infection in medical-surgical intensive care unit （ICU） inpatients in Wuxi People＇s Hospital Affiliated to Nanjing Medical University （＂our hospital＂ for short）. Methods Hospital infection data were collected through a targeted surveillance on the medical-surgical ICU inpaticnts in our hospital from January 2013 to December 2015. Results In 3523 patients admitted to the medical-surgical ICU （with 31 473 days of total hospitalization stay）, 374 were found infected. The incidence of in-hospital infection was 10.62%, and 11.81‰ for the incidence per patient-day, the incidence of one thousand-day infection was 11.88‰. The infection rate reduced year by year. The device utilization ratios of ventilator, central venous catheter and urinary catheter were 44.48%, 49.83% and 73.35%, while the incidence of ventilator-associated pneumonia, central line-asso- ciated bloodstream infection and catheter-associated urinary tract infection were 10.64%o, 2.55‰ and 2.43‰ respectively, the infection rate reduced year by year. Predominant bacteria species found in these cases were Gram-negatives and the main stay of pathogenic species were Acinetobacter baumanmii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, etc. Conclusion The incidence of hospital infection in our hospital is similar to other hospitals in Jiangsu Province, but higher than the national average in China. To control and reduce the happening of the ICU hospital infection, more efforts should be made such as taking positive and effective preventive measures, optimizing the improvement measures, and so on.