摘要
目的分析重症监护室(ICU)患者发生医院感染、器械相关感染和感染病原菌分布情况.方法收集2018年1月-2022年12月上海交通大学医学院附属仁济医院综合ICU住院患者医院感染监测数据,进行统计分析.结果共监测ICU患者9422例,医院感染发病率为2.77%,例次发病率为3.77%,医院感染发病率在2018-2022年差异有统计学意义(P<0.05),各年间医院感染例次发病率差异有统计学意义(P<0.05).医院感染主要分布在呼吸系统(28.22%)、血液系统(23.93%)和泌尿系统(17.48%).中央静脉插管、尿道插管、呼吸机插管使用率分别为62.44%、68.41%、57.09%,中央导管相关血流感染(CLRBSI)、导尿管相关尿路感染(CAUTI)和呼吸机相关肺炎(VAP)发病率分别为0.39‰、1.65‰、1.45‰;2018-2021年VAP发病率呈上升趋势(P<0.05).共分离344株病原菌,居前3位病原菌分别为真菌(22.09%)、鲍氏不动杆菌(21.22%)和肺炎克雷伯菌(10.17%).结论综合ICU患者医院感染发生率较高,VAP发病率有上升趋势,应加强导管相关感染监测和干预措施,降低医院感染,保证医疗质量安全.
OBJECTIVE To investigate the incidence of nosocomial infection,device-associated infection and distribution of pathogens in patients of intensive care unit(ICU).METHODS The monitoring data of nosocomial infection were collected from the patients who were hospitalized in ICU of Renji Hospital,Shanghai Jiao Tong University from Jan 2018 to Dec 2022 and were statistically analyzed.RESULTS Among 9422 ICU patients who were monitored,the morbidity rate of nosocomial infection was 2.77%,the case-time morbidity rate was 3.77%,and there was significant difference in the morbidity rate of nosocomial infection among 2018-2022(P<0.05);there was significant difference in the case-time morbidity rate of nosocomial infection among the years(P<0.05).Among the patients with nosocomial infection,the patients with respiratory system infection accounted for 28.22%,the patients with blood system infection accounted for 23.93%,and the patients with urinary system infection accounted for 17.48%.The utilization rates of central venous catheter,urinary tract catheter and ventilator catheter were 62.44%,68.41%and 57.09%,respectively.The morbidity rates of central catheter-related bloodstream infection,catheter-associated urinary tract infection(CAUTI)and ventilator-associated pneumonia(VAP)were 0.39%o,1.65%o and 1.45%o,respectively.The morbidity rate of VAP showed an upward trend from 2018 to 2021(P<0.05).Totally 344 strains of pathogens were isolated;fungi(22.09%),Acinetobacter baumannii(21.22%)and Klebsiella pneumoniae(10.17%)ranked the top 3 species of pathogens.CONCLUSION The incidence of nosocomial infection is high among the ICU patients,the morbidity rate of VAP shows an upward trend.It is necessary to strengthen the monitoring of catheter-related infections and take intervention measures so as to reduce the incidence of nosocomial infection and ensure the medical safety.
作者
杨亚
孙艺文
黄妹
陆峰
蔡冰超
沈瑞红
袁雅赟
张志贇
秦娟秀
厉燕
周文琴
傅小芳
班海群
YANG Ya;SUN Yi-wen;HAUNG Mei;LU Feng;CAI Bing-chao;SHEN Rui-hong;YUAN Ya-yun;ZHANG Zhi-yun;QIN Juan-xiu;LI Yan;ZHOU Wen-qin;FU Xiao-fang;BAN Hai-qun(Renji Hospital,Shanghai Jiao Tong University,Shanghai 200127,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第21期3332-3336,共5页
Chinese Journal of Nosocomiology
基金
上海市浦江人才计划基金资助项目(22PJD041)
上海交通大学医学院院感科研基金资助项目(Jyyg2202、Jyyg2203)
上海申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22022213)。
关键词
重症监护室
医院感染
监测
器械相关感染
趋势分析
Intensive care unit
Nosocomial infection
Monitoring
Device-associated infection
Trend analysis
