ICU常用医疗器械工作状态时的病原菌动态监测及院感预防措施  

Dynamic Monitoring of Pathogenic Bacteria in ICU Medical Devices in Working Condition and the Prevention Measures for Nosocomial Infections

作　　者：殷玉华[1] 刘杨[1] 张秋莹[1] 

机构地区：[1]湖北省随州市中心医院(湖北医药学院附属随州医院),湖北随州441300

出　　处：《实用预防医学》2013年第5期604-606,共3页Practical Preventive Medicine

摘　　要：目的了解ICU常用医疗器械在自然工作状态下病原菌分布情况,观察使用时间与菌群变化的相关性,以制定相应对策,从而有效降低医院感染的发生率。方法对本院ICU患者所使用的医疗器械进行动态采样监测,采样时间分别为使用(48±2)、(72±2)、(96±2)h。采样的标本分别培养鉴定。结果共采集使用中医疗器械11种,每次采集300份标本,三个时间段共计900份,阳性标本720份,分离菌株819株,并且部分使用中的医疗器械分离出复数菌株。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,其中铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌位居前三位。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其次。结论 ICU内发生的医院感染确实与医疗器械高频率、长时间使用使用率有关。使用侵入性诊疗期间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 pathogenic bacteria distribution of commonly used ICU medical devices in working condition,to observe the correlation between the use time of the devices and the changes of microflora so as to formulate the targeted countermeasures and reduce the incidence of nosocomial infections.Methods Dynamic sampling and monitoring of ICU medical devices in Suizhou Central Hospital were conducted,and the sampling time points were（48±2）,（72±2）,and（96±2） hours,respectively.The specimens were cultured and identified.Results Altogether 11 kinds of medical apparatuses were collected.A total of 900 specimens were collected through 3 sampling time points（each n=300）.There were 720 positive specimens detected and 819 strains identified.And complex strains were also isolated in part of the medical devices.The main bacteria in ICU medical devices in using were gram-negative bacilli,and the top three were Pseudomonas aeruginosa,Acinetobacter baumannii,and Escherichia coli.The positive rate of pathogenic bacteria in indwelling urinary catheter was the highest,followed by outfall of wall tube of central oxygen supply and oxygen humidifier bottle.Conclusions The results show that the nosocomial infections occurred in ICU are definitely related to the high frequency and long-time usage of medical devices.It is necessary to strengthen the targeted monitoring of environmental bacteria and take active control measures during invasive diagnosis and treatment period so as to reduce nosocomial infections and improve patients＇ outcomes.

关 键 词：ICU 医疗器械 动态监测 病原菌 医院感染 预防措施 

分 类 号：R378[医药卫生—病原生物学]