北京市某三级甲等医院综合重症监护病房患者器械相关感染的监测分析  

Device-associated infection in medical-surgical intensive care unit inpatients of an A-level, tertiary class hospital in Beijing

作　　者：王少利[1] 安卫红[2] 李宏亮[2] 袁晓宁[1] 朱曦[2] 杨雪松[1] 

机构地区：[1]北京大学第三医院医院感染管理及疾病预防控制科,100191 [2]北京大学第三医院医院危重医学科,100191

出　　处：《中国危重病急救医学》2011年第11期681-684,共4页Chinese Critical Care Medicine

基　　金：首都医学发展科研基金资助项目（2009-3029）

摘　　要：目的了解北京市某三级甲等（三甲）医院综合重症监护病房（ICU）患者器械相关感染的现状及特点。方法采用连续病例监测的方法，对北京市某三甲医院ICU2008年1月至2010年12月所有住院患者器械使用情况的监测数据进行分析。结果该院ICU住院患者共2279例，住院日15332d，发生医院感染283例、376例次，感染率为12．42％，感染例次率为16．50％，千日感染率为24．52‰；呼吸机、中心静脉导管以及导尿管的留置率分别为56．76％、59．01％及80．07％；呼吸机相关性肺炎、中心静脉相关性血行感染及尿管相关性泌尿道感染的发生率分别为16．32‰、4．09‰及3．50‰；3种器械相关感染所涉及的病原菌主要为鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌和白假丝酵母菌等。结论北京市某三甲医院综合ICU患者各器械相关感染率与我国及其他发展中国家相似，但明显高于美国医院；预防和控制器械相关感染需要医师、护士、患者、管理人员等多方人员的共同努力。Objective To understand the situation of the device-associated infection （DAI） in the medical-surgical intensive care unit （ICU） inpatients in an A-level tertiary class hospital in Beijing. Methods DAI date were collected through a surveillance on the medical surgical ICU inpatients in an A-level tertiary class hospital in Beijing from January 2008 to December 2010. Results In 2 279 patients admitted to the medical-surgical ICU （with a 15 332 days total hospitalization stay）, 283 were found infected. The incidence for in-hospital infection was 12.42%, and 24.52‰ for the incidence per patient-day. The device utilization ratios for ventilator, central venous catheter and urinary catheter were 56.76%, 59.01% and 80.07% respectively while the incidence for ventilator-associated pneumonia （VAP）, central line-associated bloodstream infection （CLABSI） and catheter-associated urinary tract infection （CAUTI） were 16.32‰, 4.09‰ and 3.50‰ respectively. The predominant bacteria species found in these cases were Gram-negatives and the main stay of pathogenic species were A. baurnannii, P. aeruginosa, Staphylococcus, E. coli, K. pneumoniae and C. albicans etc. Conclusion The incidence of DAI in the surveyed hospital is close to other hospitals in China and other developing countries but higher than hospitals in United States. More efforts should be made for its prevention/control by hospital stuff, with the cooperation from the patients.

关 键 词：医院感染 监测 住院患者 器械相关感染 

分 类 号：R181.3[医药卫生—流行病学]