江苏省医院ICU器械相关感染调查

ICU device-associated infection in hospitals of Jiangsu province

目的分析江苏省不同区域二级及以上医疗机构综合ICU器械相关感染发生情况,查找存在差距,为开展有针对性持续改进提供依据。方法将全省按照位置划分为苏南、苏中和苏北等三个区域,采用回顾性调查的方法,对比分析不同区域医疗机构综合ICU器械相关感染率。结果感染率方面,苏北地区ICU医院感染率均低于苏中和苏南地区(P<0.05),而调整后日感染率则以苏北地区最高;呼吸机相关性肺炎(VAP)发生率方面,质控范围调整前苏北地区高于苏中和苏南地区,质控范围调整后苏南地区VAP发生率较高;导管相关性血流感染(CRBSI)发生率方面,苏中地区高于苏北和苏南地区;导尿管相关性尿路感染(CAUTI)发生率方面,全省总体保持平稳趋势,以苏南地区较高,苏北地区最低。结论在全省总体质控ICU器械相关感染率总体下降的趋势下,不同区域VAP、CRBSI和CAUTI各有特点,应有针对性开展相应预防控制措施。

OBJECTIVE To investigate the prevalence of ICU device-associated infection in secondary or above medical institutions of different areas in Jiangsu province and find out the gaps so as to develop targeted continuous improvement measures.METHODS The whole province was divided into three areas southern Jiangsu province,central Jiangsu province and northern Jiangsu province according to the geographic locations.A retrospective survey was conducted to investigate the prevalence of ICU device-associated infection in the medical institutions of the three areas.RESULTS The incidence rate of nosocomial infection in ICU was significantly lower in northern Jiangsu province than in the central and southern Jiangsu province(P<0.05),however,the adjusted daily infection rate was the highest in northern Jiangsu province.The incidence rate of ventilator-associated infection(VAP)was higher in the northern Jiangsu province than in central and southern Jiangsu province before the quality control range was adjusted,and the incidence rate of VAP was higher in southern Jiangsu province after the quality control range was adjusted.The incidence rate of catheter-related bloodstream infection(CRBSI)was higher in central Jiangsu province than in northern and southern Jiangsu province.The whole province maintained an overall stable trend in the incidence rate of catheter-associated urinary tract infection(CAUTI),and it was relatively high in southern Jiangsu province and was the lowest in northern Jiangsu province.CONCLUSION The incidence of ICU device-associated infection shows an overall downward trend across the whole province,the areas vary in the incidence of VAP,CRBSI and CAUTI.It is necessary to take targeted prevention and control measures.