神经内科重症监护病房医院感染调查及护理对策

Investigation of Nosocomial Infections and Nursing Strategies in Controlling Infection in Neurological Intensive Care Unit Settings

目的 对神经内科重症监护病房 (NICU)患者医院感染发生情况及病原菌流行病学进行调查分析 ,提出医院感染控制措施。方法 调查 2 0 0 1年 4月至 9月期间NICU 6 1例住院患者医院感染发生情况 ,分析所分离出病原菌的分布及耐药情况。结果 医院感染发生率为 6 3.9% (39/ 6 1) ,其中肺部感染发生率 5 4 9% (2 8/ 5 1)。分离出的病原菌仍以革兰阴性菌为主 (34/ 70 ) ,其次为革兰阳性菌 (2 4 / 70 )和真菌 (12 / 70 )。革兰阴性菌以铜绿假单胞菌居首位 ,且呈多重耐药 ,MRSA分离率占葡萄球菌的 6 6 .7% (10 / 15 )。结论 NICU内医院感染发生率较普通病房高 ,医院感染病原菌复杂且对抗菌药物呈现多重耐药。应合理选用抗菌药物 ,医护人员要严格无菌技术操作和消毒隔离管理 。

To investigate and analyze nosocomial infection incidence and pathogen epidemiology in NICU, and to define nursing strategies for controlling infection.Methods 61 patients admitted in NICU were prospectively studied during April to September 2001. Nosocomial infection incidence, pathogens and drug resistance were analyzed.Results The incidence of nosocomial infection was 63.9% (39/61), with pneumonia predominating (28/51). The most prevalent isolates of pathogens remained to be Gram negative bacteria (34/70), Gram positive bacteria (24/70) and fungi (12/70). In Gram negative bacteria Pseudomonas aeruginosa was the major strain and in Gram positive bacteria MRSA accounted for 66.7% (10/15) among the isolated straphylococci. Gram negative bacteria were multidrug resistant.Conclusion The incidence of nosocomial infection was higher in NICU than in general wards.The pathogens for nosocomial infection were complex and multidrug resistant. Antibiotic treatment should be used properly. The strict aseptic manipulation and barrier precaution are of importance in preventing cross infection.