神经重症监护病房院内感染情况分析

In-hospital infection in neurological intensive care unit

目的探讨神经重症监护病房(NICU)住院患者院内感染的发生情况。方法 2017年武装警察部队后勤学院附属医院启动了院内感染防控专项行动。通过医院的信息管理系统收集武警后勤学院附属医院2016年1月1日至2017年12月31日NICU住院患者的临床资料,包括性别、年龄、住院时间、院内感染情况以及院内感染患者感染部位、病原体分离结果等,分析2016年与2017年的变化。结果 2016—2017年NICU住院患者共1 117例,院内感染发生率为25. 7%(287/1 117),2017年NICU住院患者院内感染发生率低于2016年[19.7%(135/685)比35. 2%(152/432)],差异有统计学意义(P <0.01)。院内感染患者共223例进行了病原体检测,检出的病原体构成比前3位分别为鲍曼不动杆菌(14.8%)、铜绿假单胞菌(12. 6%)、肺炎克雷伯菌(11. 7%)。院内感染发生部位前5位分别为下呼吸道(25.4%)、血液(13.6%)、尿路(12.9%)、腹部器官(11.2%)、皮肤或软组织(11.2%)。结论 2017年NICU患者院内感染发生率低于2016年,原因是2017年启动了院内感染防控专项行动,实施有效的感染防控措施能够大幅降低患者院内感染的发生率。

Objective To investigate the prevalence of in-hospital infection in neurological intensive care unit. Methods A retrospective study was conducted in ICU patients in Affiliated Hospital of Logistics College of Chinese People′s Armed Police Forces from 1st January 2016 to 31st December 2017. Clinical data including sex, age, hospitalization time, incidence of in-hospital infection, sites and pathogens of infection were analyzed. Results The incidence rate of in-hospital infection in 2016-2017 was 25.7%（287/1 117）. The incidence rate of in-hospital infection in 2017 was lower than that in 2016[19.7%（135/685）vs 35.2%（152/432）]（P〈0.01）. In infection patients, 223 of them had pathogen test; the top 3 pathogens were Acinetobacter baumannii（14.8%）, Pseudomonas aeruginosa（12.6%） and Klebsiella pneumoniae（11.7%）. The top 5 infection sites were lower respiratory tract（25.4%）, blood（13.6%）, urinary tract（12.9%）, abdominal organs（11.2%）, skin or soft tissue（11.2%）. Conclusion Because of effective regulation and control measures, the in-hospital infection rate in 2017 is obviously lower than that in 2016.