综合ICU医院感染的目标性监测

Targeted monitoring of nosocomial infection in comprehensive ICU

目的了解该院综合重症监护病房(ICU)医院感染情况,为预防和减少医院感染的发生提供参考依据。方法对2016-2019年入住该院综合ICU的4165例患者进行医院感染的目标性监测,分析该院医院感染率、医院感染部位分布情况、器械使用及其相关感染的发生情况。结果监测的4165例患者中,医院感染人次率为4.39%,医院感染例次率为6.43%,连续4年综合ICU医院感染人次率及感染例次率呈逐年下降趋势(P<0.05)。医院感染部位以下呼吸道为主,占45.90%。导尿管相关尿路感染、中心静脉导管相关血流感染(CLABSI)、呼吸机相关性肺炎(VAP)分别占医院感染例次数的19.03%、13.06%、21.27%。与2016、2017年相比,2018年CLABSI发生率明显下降(P<0.05)。与2016年相比,2018、2019年呼吸机使用率明显上升(P<0.05),但VAP发生率明显下降(P<0.05)。结论对综合ICU医院感染进行目标性监测,可以获得医院感染情况的变化趋势,及时采取相应的预防措施,积极控制感染。

Objective To understand the nosocomial infection in the comprehensive intensive care unit(ICU)of the hospital,and to provide a reference for preventing and reducing the occurrence of nosocomial infection.Methods Targeted monitoring of nosocomial infection was carried out on 4165 patients admitted to the comprehensive ICU of the hospital from 2016 to 2019.Analyzed the nosocomial infection rate,the distribution of nosocomial infection sites,the use of equipment and the occurrence of related infections in the hospital.Results Among the 4165 patients monitored,the nosocomial infection rate was 4.39%,and the case nosocamial infection rate was 6.43%.The nosocomial infection rate and case nosocamial infection rate for 4 consecutive years showed a decreased trend(P<0.05).The main site of nosocomial infection was lower respiratory tract,accounting for 45.90%.Catheter related urinary tract infection,central venous catheter-related bloodstream infection(CLABSI)and ventilator-associated pneumonia(VAP)accounted for 19.03%,13.06%and 21.27%of nosocomial infection cases respectively.Compared with 2016 and 2017,the incidence of CLABSI in 2018 decreased significantly(P<0.05).Compared with 2016,the ventilator utilization rate increased significantly in 2018 and 2019(P<0.05),but the incidence of VAP decreased significantly(P<0.05).Conclusion Targeted monitoring of nosocomial infection in the comprehensive ICU can obtain the changing trends of nosocomial infection,and take corresponding preventive measures in time to actively control infection.