基层医院ICU患者医院感染现状及感控措施分析

Nosocomial infection status,influencing factors and sensory control intervention of ICU patients in basic hospitals

目的分析我院ICU患者医院感染现状及影响因素,采取相应的感控措施。方法选取我院2016年—2018年ICU收治患者1157例,统计医院感染发生情况及药敏试验结果,采用单因素与多因素Logistic回归对影响因素进行分析。结果发生医院感染的患者169例,感染部位主要为下呼吸道,其中与呼吸机相关的感染占87.14%,感染患者中共分离出鲍曼不动杆菌45株,占42.86%。多因素Logistic回归结果显示住院时间、三管使用、合并症及手术为ICU患者发生医院感染的独立危险因素。结论我院ICU患者感染病原菌主要以革兰阴性菌为主,住院时间、三管使用,伴有2种以上合并症及手术等为其影响因素。必须提高医务人员的感控意识,针对易感薄弱环节加强护理干预,最大程度降低感染率,提高医院感染管理质量。

Objective To study the status and influencing factors of nosocomial infection in ICU patients in our hospital,to adopt sensory control measures for symptoms.Methods Selecting 1157 patients in ICU from 2016 to 2018,among them 169 cases were infected,infection rate 14.61%.It is much higher than the perception rate of 0.98%in the whole hospital.the univariate analysis and multivariate logistic regression analysis was used to analyze the culture identification and influencing fators of drug resistant bacteria.Results Infectious patients 169,infection site is mainly lower respiratorytract,of these,87.14%were ventilator related infections,Acinetobacter banmannii isolated from 45 infected patients accounted for 42.86%.Conclusion Gram-negative bacteria were the main pathogenic bacteria in ICU patients in our hospital,hospitalization time,three-tube use,with more than two complications have an impact on infection.Therefore,it is necessary to improve the sense of control of medical staff,aiming at vulnerable weak links,strengthening nursing measures,minimizing infection rates,improving the quality of nosocomial infection management to improve the quality of life of patients.