2009-2012年重症监护病房医院感染目标性监测分析  

Analysis on the targeted monitoring of nosocomial infections in intensive care unit in 2009-2012

作　　者：黄瑞娟[1] 曹莉[1] 黄锦芳[1] 韦妍飞[1] 张黎[1] 刘燕[1] 

机构地区：[1]广西壮族自治区南溪山医院,广西桂林541002

出　　处：《实用预防医学》2014年第3期352-353,365,共3页Practical Preventive Medicine

摘　　要：目的对重症监护病房(ICU)进行医院感染连续性目标性监测,探索有效控制ICU医院感染的方法。方法对2009-2012年在ICU住院超过48 h的628例患者进行医院感染目标性监测,2009年为回顾性调查,后三年为前瞻性调查。结果实施前瞻性目标性监测后,ICU感染率由2009年87.79‰显著降低到2010年40.34‰(χ2=13.70,P<0.01),由2011年37.82‰显著下降到2012年22.77‰(χ2=7.73,P<0.01);其中呼吸机相关性肺炎(VAP)感染率由2009年61.92‰下降到2010年36.33‰、2011年24.18‰和2012年14.94‰;导尿管相关性尿路感染(CAUTI)由2009年8.77‰下降到2010年4.48‰、2011年5.51‰、2012年2.93‰;中心静脉导管相关性血流感染(CLABSI)分别由2009年8.79‰下降到2010年7.42‰、2011年6.31‰、2012年2.56‰。结论通过连续性目标性监测评价管理措施的效果并持续改进,可有效地控制ICU医院感染。Objective To explore the effective countermeasures for nosocomial infection control by consecutive targeted monitoring in ICU.Methods A total of 628 inpatients stayed in ICU more than 48 h during 2009-2012 were targetedly monitored.We retrospectively investigated the inpatients in 2009,but prospectively investigated the inpatients in 2010-2012.Results After implementing prospective targeted monitoring,the nosocomial infection rate in ICU fell significantly from 87.79‰ in 2009 to 40.34‰ in 2010 （x2=13.70,P〈0.01） as well as from 37.82‰ in 2011 to 22.77‰ in 2012 （x2=7.73,P〈 0.01）.The incidence rate of ventilator-associated pneumonia （VAP） came down to 36.33‰ in 2010 from 61.92‰ in 2009 as well as to 14.94‰ in 2012 from 24.18‰ in 2011.The incidence rate of catheter-associated urinary tract infection （CAUTI） came down to 4.48‰ in 2010 from 8.77‰ in 2009 as well as to 2.93‰ in 2012 from 5.51‰ in 2011.The incidence rate of central line-associated bloodstream infection （CLABSI） came down to 7.42‰ in 2010 from 8.79‰ in 2009 as well as to 2.56‰ in 2012 and 6.31‰ in 2011.Conclusions Nosocomial infections in ICU can be effectively controlled by consecutive targeted monitoring,evaluation of the countermeasures and improvement of the quality of management.

关 键 词：重症监护病房 医院感染 目标性监测 

分 类 号：R181.32[医药卫生—流行病学]