摘要
目的了解徐州地区综合重症监护病房(ICU)医院感染发生情况,掌握器械相关感染的基线数据,为医院感染防控提供依据。方法采用前瞻性调查方法对徐州地区23所医院2015年入住ICU>48h的11 581例患者进行目标性监测,运用MINKE软件系统对汇总资料分析,计算医院感染率、器械使用率及器械相关感染发生率。结果共监测11 581例ICU患者,发生感染552例次,例次感染率为4.77%;住院总日数49 874d,例次千日感染率11.07‰;感染部位以呼吸系统为主,占73.37%;根据Spearman法分析,随着导尿管留置时间增长与感染的发生成正相关关系(P<0.05);共培养641株病原菌,以革兰阴性菌为主,共456株占71.14%,其次为革兰阳性菌、真菌,分别占18.72%、10.14%。结论医院感染仍以器械相关感染为主,需加强控制和监测;导尿管插管率、呼吸机相关感染率相比显著升高,应列为ICU防控重点;加强由终末监测过渡到过程监测,落实各项措施的执行。
OBJECTIVE To explore the incidence of healthcare-associated infections （HA1）, particularly the base- line of the device-associated （DA）infection in the medical-surgical intensive care unit in Xuzhou, so as to provide references for prevention and control of healthcare-associated infections. METHODS Targeted surveillance was performed on 11581 patients who stayed more than 48h in ICU during the study period from 23 hospitals of Xuzhou in 2015 using prospective investigative methods. MINKE software was employed to sum up and calculate the healthcare-associated infection rate, equipment usage rate and the incidence of device-associated infections. RESULTS Totally 11581 hospitalized patients were surveyed. There were 522 （4.77%） cases of HAIs, with the case infection rate of 4.77%, and 49874 days of hospitalization, and the case infection rate of thousand-days was 11.07%. Respiratory tract was the main site of infection, accounting for 73.37%. According to the analysis by Spearman method, with the extension of the ICU indwelling time, the CAUTI rate increased gradually in a posi- tive correlation（P〈0.05）. A total of 641 strains of pathogenic bacteria were cultured, which were mainly 456 strains of gram-negative bacteria, accounting for 71.14%, followed by gram-positive bacteria and fungi, account- ing for 18. 72% and 10.14%, respectively. CONCLUSION Device-associated infection is still the main nosocomial infection, and it needs to strengthen control and monitoring. The indwelling urinary usage rate and ventilator-as- sociated infection are significantly higher, which should be the focus of prevention and control in ICU. We should strengthen the transition from result monitoring to process monitoring and implement the measures.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第8期1875-1878,共4页
Chinese Journal of Nosocomiology
基金
江苏省卫生计生委预防医学科研课题(Y2015067)
关键词
重症监护病房
医院感染
器械相关感染
目标性监测
Intensive care unit
Healthcare-associated infection
Device-associated infection
Targeted surveillance
