ICU院内感染不同部位病原学的演变监测

A monitoring survey on the changes of pathogens in nosocomial infection by infected sites in ICU of a tertiary hospital

目的研究某三级甲等医院综合性重症医学科(ICU)既往6年的院内感染发生情况,明确不同感染部位、不同病原学的院内感染的变化趋势。方法收集2010~2015年期间ICU的院内感染病例,分析导致院内感染的不同病原菌以及不同感染部位病原学的变化趋势。结果所有院感病例中细菌培养为阳性结果的例数是884例;数量呈明显增长趋势的前三位细菌分别是泛耐药的鲍曼不动杆菌、嗜麦芽窄食假单胞菌以及人葡萄球菌。下呼吸道感染中呈显著增长趋势的是肺炎克雷伯杆菌,腹(盆)腔内组织感染呈显著增长的是粪肠球菌,导管相关性血行感染呈显著增长趋势的是表皮葡萄球菌。结论在过去的6年中,导致该院ICU院内感染的病原菌以非发酵菌为主,且多为泛耐药菌;不同感染部位病原学分布及增长有各自特点。这个结果对于指导和制定院内感染防治措施有很大的影响。

Objective Through surveying the nosocomial infection in a general intensive care unit（ ICU） of a tertiary hospital in the last6 years,in order to get the change trends of different pathogens in different infected sites. Methods The clinical data of all patients with nosocomial infection in the ICU of Beijing Friendship Hospital during 2010 to 2015 were retrospectively analyzed. Results Multi- drug resistant Acinetobacter baumannii,Stenotrophomonas maltophilia and Staphylococcus hominis were three kinds of bacteria significantly increased. Klebsiella pneumoniae was significantly increased in lower respiratory tract infection. Enterococcus faecalis was significantly increased in intra- abdominal infection. Staphylococcus epidermidis was significantly increased in catheter related bloodstream infection. Conclusion During the study period,the most common pathogens of nosocomial infection in ICU of this hospital were nonfermenters. Most of them were multi- drug resistant. The distribution of pathogens was different in infection sites. These findings have implications for implementation of infection prevention strategies.