NICU医院感染目标性监测及危险因素分析  

Targeted surveillance of nosocomial infections in NICU and analysis of risk factors

作　　者：张慧[1] 尹维佳[1] 郑勇[2] 薛欣盛[2] 宗志勇[1] 刘帆[2] 

机构地区：[1]四川大学华西医院医院感染管理科,四川成都610041 [2]四川大学华西医院医院NICU,四川成都610041

出　　处：《中华医院感染学杂志》2014年第14期3544-3546,共3页Chinese Journal of Nosocomiology

基　　金：四川省科技厅科技计划基金资助项目(2008FG0004)

摘　　要：目的对医院神经重症监护病房(NICU)发生医院感染的情况开展目标性监测,探索医院感染高发原因,为制定有效的预防控制措施提供依据。方法对2011年3月1日-12月31日入住NICU 548例患者进行前瞻性监测,重点监测呼吸机相关性肺炎、导管相关性血流感染、导尿管相关性泌尿道感染,对监测数据采用SPSS17.0软件进行统计处理。结果 NICU监测期间共发生医院感染199例、266例次,感染率36.31%、例次感染率48.54%;最常见感染部位为下呼吸道感染占57.52%,其次为泌尿道、血液感染,分别占18.05%、11.28%;病原菌以革兰阴性菌为主,占82.27%,最常见为铜绿假单胞菌占26.82%;单因素分析显示,住院时间>7d、气管切开深静脉置管、留置胃管及应用抗菌药物>14d等是医院感染的危险因素,非条件多元logistic回归分析显示,住院时间>7d和气管切开可作为独立危险因素。结论 NICU医院感染率高,应加强监测、积极干预,逐步降低医院感染的发生率。OBJECTIVE To conduct the targeted surveillance of incidence of nosocomial infections in neurosurgical intensive care unit（NICU）and explore the high-risk factors for nosocomial infections so as to put forward effective prevention measures.METHODS The prospective surveillance was conducted for 548patients who were hospitalized the NICU from Mar 1,2011to Dec 31,2011,especially for the surveillance of ventilator-associated pneumonia,catheter-related bloodstream infections,or catheter-related urinary tract infections,then the surveillance data were statistically analyzed with the use of SPSS17.0software.RESULTS The nosocomial infections occurred in 199（266case-times）cases in the NICU during the surveillance period with the infection rate of 36.31% and the case-time infection rate of 48.54%.Among the patients with nosocomial infections,the patients with lower respiratory tract infections accounted for 57.52%,the patients with urinary tract infections 18.05%,the patients with blood infections 11.28%.The gram-negative bacteria were the predominant pathogens,accounting for82.27%;the Pseudomonas aeruginosa was the most common species,accounting for 26.82%.The univariate analysis indicated that,length of hospital stay more than 7days,deep venous catheter indwelling for tracheotomy,gastric catheter indwelling,and time of antibiotic therapy more than 14days were the risk factors for the nosocomial infections;the non-conditional multivariate logisticregression analysis showed that the length of hospital stay more than 7days and tracheotomy could be defined as the independent risk factors.CONCLUSIONThe incidence of nosocomial infections is high in the NICU.It is necessary to strengthen the surveillance and actively take intervention measures so as to reduce the incidence of nosocomial infections.

关 键 词：重症监护病房 医院感染 监测 危险因素 

分 类 号：R181.32[医药卫生—流行病学]