某三级综合医院综合重症监护病房医院感染目标性监测分析

Targeted monitoring of nosocomial infection in comprehensive Intensive Care Unit in a tertiary general hospital

目的通过对重症监护病房(Intensive Care Unit,ICU)进行医院感染目标性监测,了解ICU医院感染发病率及其危险因素和多重耐药菌病原学特征,为降低医院感染的发生提供科学依据。方法 2014年7月—2016年6月对入住综合ICU的患者进行医院感染目标性监测。结果监测的4 991例综合ICU患者中共发生312例次医院内感染,例次感染率为6.25%,例次日感染率为19.03‰,调整后例次日感染率为6.77‰;呼吸机相关性肺炎发生率为30.78‰,导管相关性血流感染发生率为0.30‰,导尿管相关性尿路感染发生率为0.27‰;医院感染部位以下呼吸道感染为主(90.38%);检出的细菌主要为革兰阴性杆菌(92.74%),其中鲍曼不动杆菌占36.29%。结论通过目标性监测及时了解ICU医院感染现状,可有针对性地进行管理和干预,是降低ICU医院感染的重要途径。

Objective To investigate nosocomial infection rate in Intensive Care Unit （ICU）, its risk factors and the pathogenic characteristics of multidrug-resistant bacteria through targeted monitoring, in order to provide scientific references for reducing nosocomial infection. Methods Targeted monitoring was performed on the patients who were admitted to the comprehensive ICU between July 2014 and June 2016. Results Nosocomial infection occurred in 312 of the 4 991 patients. The case infection rate was 6.25%, and case infection rate per day was 19.03‰. After the adjustment, the case infection rate per day was 6.77‰. The ventilator-associated pneumonia infection accounted for 30.78%o; catheter- related bloodstream infection occupied 0.30‰; and catheter-associated urinary tract infection accounted for 0.27%0. The respiratory tract was the major part of nosocomial infection, accounting for 90.38%. Gram-negative bacilli were the major bacteria accounting for 92.74%, in which Acinetobacter baumannii accounted for 36.29%. Conclusions Through targeted monitoring to keep abreast of the current situation of nosocomial infection in ICU, management and interventions can be targeted. It is an important way to reduce nosocomial infection in ICU.