综合性ICU医院感染的调查分析及感染管理  

Investigation of nosocomical infections in a comprehensive ICU and infection management

作　　者：李文耀[1] 

机构地区：[1]菏泽市立医院中心ICU,山东菏泽274030

出　　处：《中华医院感染学杂志》2012年第13期2792-2794,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析综合性ICU医院感染的流行病学及病原菌耐药性,为临床防治医院感染提供依据,并探讨有效的感染管理措施,预防和控制耐药菌的传播。方法对医院综合性ICU 2010年1-12月所有分离的病原菌及其耐药性进行回顾性调查分析。结果医院感染中仍以革兰阴性菌为主,占53.6%,其中以铜绿假单胞菌最多,占17.1%;革兰阳性球菌占34.1%,以金黄色葡萄球菌为主,占16.5%,其中94.3%为耐甲氧西林金黄色葡萄球菌(MRSA);真菌占12.3%;药敏试验显示,各菌株耐药水平均较高。结论 ICU医院感染仍以革兰阴性菌为主,但革兰阳性菌及真菌已成为重要致病菌,且耐药率明显升高;应加强ICU感染管理和病原菌耐药性的监测,合理使用抗菌药物,制定有效对策,降低医院感染的发生。OBJECTIVE To analyze the epidemiology of nosocomial infections in a comprehensive ICU and the drug resistance of bacteria so as to provide evidence for clinical prevention of nosocomial infections.METHODS All of the bacteria and fungi isolated from the comprehensive ICU from Jan.to Dec.2010 and the drug resistance were retrospectively analyzed.RESULTS Gram-negative bacteria were the main pathogens causing nosocomial infections,accounting for 53.6%,Pseudomonas aeruginosa was the predominant pathogen among gram-negative bacteria,accounting for 17.1%.Gram-positive cocci accounted for 34.1%,among which Staphylococcus aureus was the predominant pathogen,accounting for 16.5%,94.3% of which were methicillin-resistant S.aureus（MRSA）.Fungi accounted for 12.3%.Drug susceptibility testing indicated that all the isolates were with high-level drug resistance.CONCLUSION Gram-negative bacteria remain the predominant pathogens causing nosocomial infections in ICU,gram-positive bacteria and fungi have become the major pathogens with a significant increase in drug resistance rate.Infection management and surveillance for bacterial resistance should be strengthened.Antibiotics should be used reasonably,and effective countermeasures should be developed so as to reduce nosocomial infections.

关 键 词：综合性重症监护病房 医院感染 调查分析 感染管理 

分 类 号：R181.32[医药卫生—流行病学]