摘要
目的对医院重症监护病房(ICU)患者医院感染的影响因素进行分析,提出相应的控制策略,降低医院感染发生率。方法随机选择2012年3月-2013年3月300例ICU患者进行调查分析,将发生医院感染的43例患者设为感染组,其余257例患者设为对照组,分析两组患者的临床资料及医疗情况,找出发生感染的影响因素。结果 300例ICU患者中发生医院感染43例,感染率为14.33%;感染部位以呼吸道为主,占51.16%,其次为手术切口与泌尿系统感染,分别占16.28%、11.63%;高龄、营养状况差,手术、住ICU、机械通气时间长,合并糖尿病、合并≥2种基础疾病、留置尿管是感染发生的主要因素,差异有统计学意义(P<0.05);共分离出病原菌47株,其中革兰阴性菌37株占78.72%,革兰阳性菌8株占17.02%,真菌2株占4.26%;以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌为主要感染病原菌。结论 ICU是耐药菌的滋生地,也是医院感染的高发科室,加强治疗过程中各环节的无菌控制,注重患者基础疾病的治疗及环境监测,合理使用抗菌药物,是降低感染的有效措施。
OBJECTIVE To analyze the effecting factors of nosocomial infections in intensive care unit （ICU）, and propose the corresponding control strategies to reduce the incidence of infections. METHODS A total of 300 cases of ICU patients were randomly selected from Mar. 2012 Mar. 2013 and were investigated and analyzed. A total of 43 patients with nosocomial infections were set as the infection group, and the remaining 257 eases were set to be the control group. The clinical data and medical conditions of the two groups were analyzed to identify factors of infections. RESULTS Among 300 ICU patients, 43 cases developed nosocomial infections, with the infection rate of 14.33%. The main site of infection was respiratory tract, accounting for 51.16%, followed by wound and urinary tract, which accounted for 16.28%, 11.63%. Advanced age, poor nutritional status, operation time, ICU length of hospital stay, long time of mechanical ventilation, combined diabetes, two or more combined underlying diseases, indwelling catheter infection were major factors of infections. The difference was significant （P〈0.05）. A total of 47 strains of pathogens were isolated, including 37 strains of gram-negative bacteria, accounting for 78.72%, 8 strains of gram-positive bacteria, accounting for 17.02%; 2 strains of fungi, accounting for 4.26%, with Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae as the main pathogens. CONCLUSION ICU is a staging ground for drug-resistant pathogens, but also a department with a high incidence of nosocomial infections. Strengthening the sterile control of all aspects of the treatment process, focusing on the treatment of patients with underlying diseases and environmental monitoring, rational use of antibiotics are effective measures to reduce the infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第11期2699-2701,共3页
Chinese Journal of Nosocomiology
基金
莱芜市医学科研基金项目(莱科成鉴字[2010]120)
关键词
重症监护病房
感染
影响因素
控制
Intensive care unit
Infection
Influencing factors
Control
