某综合医院ICU导管相关感染及多重耐药菌分析

Analysis of catheter related infections and multidrug resistant bacteria at ICU in a hospital

目的了解某综合医院ICU导管相关感染及多重耐药菌分布情况,为持续质量改进和完善医院ICU感染防控措施提供科学依据。方法调查并分析2018年1-12月某医院ICU住院病人医院感染目标性监测及多重耐药菌分布情况。结果共监测ICU住院病人990例,共发生导管相关感染35例,感染率3.54%,以呼吸机相关性肺炎为主、感染率13.567‰,泌尿道插管相关性泌尿道感染率为2.214‰,血管导管相关性血流感染率为1.339‰;该医院ICU住院感染病人标本共分离多重耐药菌76株,其中革兰阴性菌占96.05%,居前五位的病原菌依次为产ESBLs大肠埃希菌、耐碳青霉烯类铜绿假单胞菌(CR-PA)、耐碳青霉烯类鲍曼不动杆菌(CR-AB)、产ESBLs肺炎克雷伯菌、耐碳青霉烯类肠杆菌(CRE)。结论ICU是医院感染的高危科室,感染病原菌以革兰阴性菌为主;应加强导管相关感染监测和防控。

Objective To understand the catheter-related infections and the distribution of multidrug resistant bacteria at the intensive care unit(ICU)in a general hospital,so as to provide scientific basis for continuously improving infection control and prevention at ICU in the hospital.Methods Targeted surveillance of infection and distribution of multidrug resistant bacteria were performed and analyzed in the inpatients at ICU in a general hospital of three level from January to December,2018.Results There were 990 cases of inpatient monitored at ICU,and catheter related infection occurred in 35 cases with infection rate of 3.54%.Among the infected patients,the infection rate was 13.567‰of ventilator-associated pneumonia(VAP),2.214‰of urinary tract infection related to urethral catheter,and 1.339‰of bloodstream infection related to central venous catheter.There were 76 strains of multidrug resistant bacteria isolated from the samples of the cases at ICU,including 96.05%of gram-negative bacteria.The top five pathogenic bacteria orderly were ESBLs-producing Escherichia coli,carbon-resistant Pseudomonas aeruginosa(CR-PA),carbon-resistant Acetobacter baumannii(CR-AB),ESBLsproducing Klebsiella pneumonia and carbon-resistant Enteric bacilli(CRE).Conclusions ICU is the department with high risk of infection in hospital.Gram-negative bacillus is the dominant in pathogenic bacteria.The surveillance and prevention of catheter-related infection should be strengthened.