ICU常用医疗器械使用中带菌分析及医院感染控制对策  

Bacteria from medical instruments commonly used in ICU and control countermeasures of nosocomial infections

作　　者：殷玉华[1] 刘杨[1] 吕朝阳[1] 吴超英[1] 李奎[1] 

机构地区：[1]随州市中心医院医院感染管理科,湖北随州441300

出　　处：《中华医院感染学杂志》2013年第9期2152-2154,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解重症监护病房(ICU)日常使用的医疗器械在自然工作状态下细菌携带率和病原菌分布情况,以制定相应对策,从而有效降低医院感染的发生率。方法对医院ICU患者所使用的医疗器械进行采样,培养鉴定分析。结果共采集使用中医疗器械11种,300份标本,阳性217份阳性率72.3%;分离菌株242株,其中革兰阴性杆菌184株占76.0%,其中铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌居前3位;革兰阳性球菌41株占17.0%;留置导尿管检出率最高,使用48h病原菌检出率为89.5%,其次为氧气湿化瓶检出率为89.3%;并且部分使用中的医疗器械分离出复数菌株。结论 ICU使用中医疗器械的带菌情况主要还是以革兰阴性杆菌为主,留置尿管的病原菌检出阳性率最高,中心供氧壁管出口和氧气湿化瓶的病原菌带菌率次之;证明ICU内发生的医院感染确实与医疗器械高频率、长时间使用有关;应加强环境细菌的目标性监测,采取积极的控制措施,降低医院感染率,改善患者预后。OBJECTIVE To investigate the bacteria carrying rate and distribution of pathogenic bacteria isolated from the commonly used medical devices in ICU under the natural working state so as to set down the corresponding countermeasures to reduce the incidence of nosocomial infections.METHODS All the medical instrument that were used in the ICU were sampled for bacterial culture and identification.RESULTS A total of 11 medical instruments under working state were collected,and 217 of 300 samples were tested positive with the positive rate of 73.2%.A total of 242 strains of pathogens were isolated,including 184（76.0%） strains of gram-negative bacilli,41（17.0%） strains of gram-positive cocci,and 17（7.0%） strains of other species of pathogens.Pseudomonas aeruginosa,Acinetobacter baumannii,and Escherichia coli were the most predominant species of the gram-negative bacilli.The majority of the strains were isolated from the indwelling catheters,and the detection rate of the pathogens from the medical instruments used for 48 hours was 89.5%,followed by the oxygen humidification bottle（89.3%）.And complex strains have been isolated from some of the medical equipments under the working state.CONCLUSION The main bacteria cultured from medical devices in the ICU are the gram-negative bacilli,the positive rate of the pathogens isolated from the indwelling catheters is the highest,followed by the central oxygen supply pipe outlet and an oxygen humidifying bottle.It is concluded that the incidence of nosocomial infections is definitely correlated with the highly frequent and extended use of the medical instruments.It is necessary to strengthen the targeted monitoring of environmental bacteria and take effective control measures so as to reduce the incidence of nosocomial infections and improve the patients’prognosis.

关 键 词：重症监护病房 医疗器械 病原菌 医院感染 对策 

分 类 号：R187[医药卫生—流行病学]