2015—2019年某院综合ICU医院感染目标性监测分析

Analysis on objective monitoring of nosocomial infection in general ICU of a hospital from 2015 to 2019

目的分析2015—2019年某院综合ICU医院感染和器械相关性感染发病率、感染部位分布及病原菌检出情况,评价目标性监测对综合ICU医院感染防控的价值。方法采用目标性监测法收集2015—2019年某院综合ICU收治患者医院感染情况、器械相关感染、医院感染部位分布及病原菌检出情况,进行统计学分析。结果 2015—2019年某院综合ICU医院感染发病率为13.97%,调整后感染发病率为3.53%,连续5年医院感染发病率差异有统计学意义(χ^(2)=10.211,P<0.05),组间变量年份和感染率的线性趋势检验,差异有统计学意义(χ^(2)=9.966,P<0.05)。器械相关感染发病率:呼吸机相关性肺炎(VAP):9.08‰,导尿管相关泌尿系感染(CAUTI):1.33‰,血管内导管相关性血流感染(CLABSI):2.07‰。连续5年呼吸机相关肺炎发病率(χ^(2)=5.836,P>0.05)、导尿管相关泌尿系感染(χ^(2)=4.827,P>0.05)、血管内导管相关性血流感染发病率(χ^(2)=2.424,P>0.05)差异均无统计学意义。前3位医院感染部位分别为下呼吸道399例(68.79%)、泌尿道64例(11.03%)、血液40例(6.90%)。前3位医院感染病原体分别为鲍曼不动杆菌167株(26.72%)、肺炎克雷伯菌102株(16.32%)、铜绿假单胞菌86株(13.76%)。结论通过目标性监测可有效评价医院感染情况,发现感控管理中存在的问题,进行提前干预,以降低综合ICU医院感染发病率。

Objective To analyze the incidence of nosocomial infection and device-related infection in general ICU,distribution of infection sites and detection of pathogenic bacteria from 2015 to 2019,and to evaluate the value of objective monitoring for prevention and control of nosocomial infection in general ICU.Methods Objective monitoring technique was used to collect the nosocomial infection, device-related infection, distribution of nosocomial infection site and pathogenic bacteria detections of patients admitted in general ICU of a hospital from January 2015 to December 2019 for statistical analysis.Results The incidence of nosocomial infection in general ICU of a hospital from 2015 to 2019 was 13.97%,and the adjusted incidence was 3.53%.The incidence of nosocomial infection for 5 consecutive years was statistically significant(χ^(2)=10.211,P<0.05).The differences in linear trend tests on inter-group variable year and infection rate were statistically significant(χ^(2)=9.966,P<0.05).The incidence of device-related infection was as follows: ventilator-associated pneumonia(VAP):9.08‰,catheter associated urinary tract infection(CAUTI):1.33‰,intravascular catheter-related bloodstream infections(CLABSI):2.07‰.The difference in the incidence of VAP(χ^(2)=5.836,P>0.05),CAUTI(χ^(2)=4.827,P>0.05) and CLABSI(χ^(2)=2.424,P>0.05) for 5 consecutive years wasn′t statistically significant.The top three nosocomial infection sites were lower respiratory tract with 399 cases(68.79%),urinary tract with 64 cases(11.03%) and blood with 40 cases(6.90%).The top three pathogens of nosocomial infection were 167 strains of Acinetobacter baumannii(26.72%),102 strains of Klebsiella pneumoniae(16.32%) and 86 strains of Pseudomonas aeruginosa(13.76%).Conclusion Objective monitoring can effectively evaluate the situation of nosocomial infection, find problems in infection control management, and early intervention is allowed to be conducted to reduce the incidence of nosocomial infection in general ICU.