摘要
目的了解不同类别的重症监护病房(ICU)患者医院感染发病率、器械使用率及其相关感染发病率。方法收集某三级甲等教学医院2015年7月1日—2018年6月30日6个不同类别ICU患者医院感染前瞻性目标性监测资料,对其进行统计分析。结果不同类别ICU持续3年共监测患者21 485例,医院感染发病率为5. 77%,例次发病率为7. 33%,持续3年医院感染发病率、例次发病率比较,差异均有统计学意义(均P <0. 05)。经平均病情严重程度调整后,以综合ICU患者医院感染调整日发病率和调整例次日发病率最高。所有不同类别的ICU持续3年中央血管导管、导尿管、呼吸机使用率分别为31. 65%、77. 07%、26. 08%;中央导管相关血流感染(CLABSI)、导尿管相关尿路感染(CAUTI)、呼吸机相关肺炎(VAP)发病率分别为2. 90‰、2. 08‰、5. 37‰;CLABSI发病率以呼吸ICU最高(4. 85‰),CAUTI发病率以儿科ICU最高(5. 53‰),VAP发病率以神经外科ICU最高(9. 33‰)。居前3位的医院感染部位分别为下呼吸道(36. 00%)、血液(17. 52%)、胃肠道(13. 08%),居前3位的医院感染病原体分别为鲍曼不动杆菌(27. 74%)、肺炎克雷伯菌(13. 18%)、铜绿假单胞菌(7. 76%)。结论应根据不同类别ICU的医院感染特点,制定相应的医院感染预防与控制措施,降低ICU医院感染发病率。
Objective To understand the incidence of healthcare -associated infection(HAI),device usage rate,and incidence of related infection in patients in different types of intensive care units(ICUs).Methods Prospective targeted surveillance data of HAI in patients in 6 different types of ICUs from July 1,2015 to June 30,2018 in a tertiary first-class teaching hospital were collected and analyzed statistically.Results A total of 21 485 patients in all different ICUs were monitored for three consecutive years,incidence and case incidence of HAI were 5.77% and 7.33% respectively,there were significant differences in incidence and case incidence of HAI among three years(all P <0.05).After adjusting average severity of illness score(ASIS),the adjusted incidence and adjusted case incidence per 1 000 bed-day in patients in general ICU were the highest.The utilization rates of central vascular catheter,urinary catheter,and ventilator in all different ICUs were 31.65%,77.07%,and 26.08% respectively;incidences of central line -associated bloodstream infection (CLABSI),catheter-associated urinary tract infection (CAUTI),and ventilator-associated pneumonia (VAP) were 2.90‰,2.08‰,and 5.37‰ respectively.Incidence of CLABSI was highest in respiratory ICU(4.85‰),incidence of CAUTI was highest in pediatric ICU(5.53‰),incidence of VAP was highest in neurosurgical ICU(9.33‰).The top 3 HAI sites were lower respiratory tract ( 36.00%),blood (17.52%),and gastrointestinal tract (13.08%);the top 3 pathogens of HAI were Acinetobacter baumannii ( 27.74%),Klebsiella pneumoniae (13.18%),and Pseudomonas aeruginosa (7.76%).Conclusion Corresponding preventive and control measures should be formulated according to the characteristics of HAI in different types of ICUs,so as to reduce the incidence of HAI in ICUs.
作者
刘思娣
黄勋
曾翠
龚瑞娥
付陈超
周鹏程
吴红曼
汪要望
汤紫媛
张莹
吴安华
LIU Si-di;HUANG Xun;ZENG Cui;GONG Rui-e;FU Chen-chao;ZHOU Peng-cheng;WU Hong-man;WANG Yao-wang;TANG Zi-yuan;ZHANG Ying;WU An-hua(Healthcare -associated Infection Control Center,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2019年第1期17-21,共5页
Chinese Journal of Infection Control
关键词
重症监护病房
医院感染
前瞻性监测
目标性监测
器械使用率
器械相关感染发病率
intensive care unit
healthcare -associated infection
prospective surveillance
targeted surveillance
utilization rate of device
device -related infection rate
