2018—2021年某医院急诊重症医学科医院感染目标监测分析

Analysis of nosocomial infection targets in the department of emergency intensive care in a hospital from 2018 to 2021

目的了解青海某医院急诊重症医学科(EICU)连续4年医院感染变化及多重耐药菌(MDRO)分布情况。方法对2018—2021年EICU监测指标包括医院感染指标监测基本数据、医院感染部位分布、“三管”使用及其相关感染状况、MDRO检测情况进行汇总分析。结果2018—2021年共监测EICU住院患者2249例,医院感染发病率为8.40%,例次感染发病率为10.58%,4年总体医院感染发病率差异无统计学意义。其中呼吸系统占59.24%,泌尿系统占20.17%,血液系统占6.73%,4年呼吸系统和血液系统感染率差异有统计学意义(P<0.05)。器械相关感染中,VAP占13.67‰,CAUTI占3.65‰,CRBSI占0.31‰,4年间“三管”感染发病率差异无统计学意义。MDRO检出以革兰阴性菌为主,(占71.22%),主要为鲍曼不动杆菌,占46.70%,CRE检出株数较上年度均有所增多。结论EICU医院感染中发生VAP、CAUTI相关感染的人群是感控重点关注人群,MDRO管理需重点关注。

Objective To investigate the change of nosocomial infection and the distribution of multidrug resistant bacteria in emergency intensive care unit(EICU)in high altitude area for 4 years.Methods The monitoring indexes of EICU from 2018 to 2021 include basic data of nosocomial infection index monitoring,nosocomial infection site distribution,use of three tubes and related infection status,the detection of multidrug resistant bacteria were summarized and analyzed.Results From 2018 to 2021,a total of 2249 inpatients with EICU were monitored,with a nosocomial infection incidence rate of 8.40%and a nosocomial infection incidence of 10.58%,and the overall nosocomial infection incidence rate had no statistically significant in 4 years.The respiratory system accounted for 59.24%,the urinary system accounted for 20.17%,and the blood system accounted for 6.73%,and the difference in the infection rate between the respiratory system and the blood system in 4 years was statistically significant(all P<0.05).VAP accounted for 13.67‰,CAUTI accounted for 3.65‰,CRBSI accounted for 0.31‰,and there was no significant difference in the incidence of“three-tube”infection in 4 years.The detection of multidrug-resistant bacteria was mainly gram-negative bacteria,accounting for 71.22%,and the first was Acinetobacter baumannii,accounting for 46.70%.and the number of CRE detected increased compared with the previous year.Conclusion The population with VAP and CAUTI-related infections in nosocomial infections in EICU is the focus of infection control,and the management of multidrug-resistant bacteria needs to be focused.