摘要
目的评价实施多种干预措施对ICU预防控制医院感染的作用。方法利用医院感染实时监控系统,对2011年1月-2012年3月ICU的医院感染情况进行监测。结果监测期间9个ICU共有住院患者5269例,发生医院感染224例、254例次,感染率为4.25%、例次感染率为4.82%,平均病情严重程度ASIS评分为3.35分;呼吸机的平均使用率为13.29%,呼吸机相关性肺炎(VAP)的发病率为8.50‰,中心静脉导管的平均使用率为29.93%,中心静脉导管相关性血流感染(CRBSI)的发病率为1.17‰,留置导尿管的平均使用率为45.89%,导尿管相关性尿路感染的发病率为1.83‰;9个ICU感染例次率由干预前2011年第一季度的4.26%逐步降至干预后2012年同期的3.47%,以VAP感染率下降最为明显,由干预前2011年第一季度的15.80‰逐步降至干预后2012年同期的5.30%;感染部位主要是下呼吸道,占67.72%,其次是泌尿道、血流,分别占9.45%、6.69%;检出病原菌以鲍氏不动杆菌居多,其次是金黄色葡萄球菌,分别占20.80%、18.81%。结论实施多种简单、易行的干预措施,对ICU预防和控制医院感染具有积极的促进作用,但VAP感染率仍较NHSN、北京市三级医院ICU的数据为高,还需重点加强VAP干预措施的制定。
OBJECTIVE To assess the effect of the combined interventions on the prevention and control of nosocomial infections in the ICUs.METHODS Real-time monitoring system was used to monitor the status of nosocomial infections from Jan,2011 to Mar,2012 in the ICUs.RESULTS A total of 5269 patients in 9 ICUs were monitored,among which 224 cases and 254 case/times of nosocomial infections occurred and the infection rate was 4.25%,while the case-time infection rate was 4.82%.The average severity score was 3.35 points ASIS.The utilization rate of the ventilator was 13.29%,and the incidence of the ventilator-associated pneumonia was 8.50‰,the average utilization rate of the central venous catheter was 29.93%,the incidence rate of the catheter-related blood stream infections was 1.17‰,the average utilization rate of indwelling catheter was 45.89%,the incidence of the catheter-related urinary tract infections was 1.83‰;the case-time infection rate in the 9 ICUs declined from 4.26% during first quarter 2011 before intervention to 3.47% the same time 2012 after intervention,the incidence of VAP decreased most significantly,which dropped from 15.80‰ during first quarter 2011 before the interventions to 5.30‰ the same time 2012 after the interventions;the lower respiratory tract,accounting for 67.7%,was the main infection site,followed by the urinary tract（9.45%） and blood stream（6.69%）;Acinetobacter baumannii and Staphylococcus aureus were the most predominant isolated species,accounting for 20.80% and 18.81%,respectively.CONCLUSION The simple and feasible multiple interventions can promote the prevention and control of nosocomial infections in ICU,but the incidence of VAP is relatively high as compared with that of NHSN and the Class Three Hospital ICU of Beijing,thus it should put emphasis on the constitution of the VAP interventions.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第14期3022-3024,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
医院感染
干预措施
Intensive care unit
Nosocomial infection
Intervention
