ICU医院感染暴发事件的特征与预防控制  

Epidemiological characteristics of outbreak of healthcare-associated infections in ICUs and prevention and control measures

作　　者：程丽峰[1] 李春辉[2] 任南[2] 吴红曼[2] 张莹[2] 吴安华[2] 

机构地区：[1]新疆生产建设兵团第一师医院感染办,新疆阿克苏843000 [2]中南大学湘雅医院感染控制中心,湖南长沙410008

出　　处：《中华医院感染学杂志》2015年第21期4985-4987,共3页Chinese Journal of Nosocomiology

基　　金：湖南省科技计划基金资助项目(2012SK3200)

摘　　要：目的了解近年重症监护病房(ICU)医院感染暴发的流行病学特征,为实施感染预防控制措施提供参考依据。方法通过文献检索系统,对2002年1月-2013年12月ICU发生的医院感染暴发或疑似暴发事件进行检索,逐一阅读文献填写调查表,将调查内容录入Excel表建立数据库,并对相关数据进行汇总分析。结果共检索到ICU医院感染暴发事件64起,感染部位以下呼吸道感染最多,56起占87.50%;感染病原菌分布以鲍氏不动杆菌最多,检出31株占48.44%;其次为耐甲氧西林金黄色葡萄球菌,12起占18.75%;对病原菌进行分子生物学同源分析的仅有11起,占17.19%;科室分布以综合ICU最多46起,占71.88%,其次为呼吸内科ICU和神经外科ICU,各4起,分别占6.25%;其中60起暴发事件与接触传播有关,34起暴发事件与工作人员手卫生有关,21起暴发事件与床头柜污染相关;17起暴发事件与床栏相关。结论 ICU医院感染暴发事件以接触传播为主,多与医务人员的手和患者周围环境有关,因此,加强医务人员手卫生和无菌操作,重视环境、物体表面消毒工作,可以有效降低ICU医院感染暴发的发生。OBJECTIVE To investigate the epidemiological characteristics of outbreak of healthcare-associated infections in intensive care unites（ICUs）in recent years so as to provide guidance for prevention and control of the infections.METHODS By means of literature retrieval systems,the outbreaks of the healthcare-associated infections or suspected outbreak incidents in the ICUs were retrieved from Jan 2002 to Dec 2013,the literatures were reviewed one by one to fill out the questionnaires,the survey contents were input into the Excel table to establish the database,and the related data were summarized and analyzed.RESULTS Totally 64 incidents of outbreaks of healthcare-associated infections in the ICU were retrieved,of which 56（87.50%）had the lower respiratory tract infections;31（48.44%）had the Acinetobacter baumannii infection,followed by the methicillin-resistant Staphylococcus aureus infection（12,18.75%）;the molecular biological homology of the pathogens was analyzed for only11（17.19%）incidents;46（71.88%）incidents distributed in the general ICUs,followed by the ICUs of respiratory medicine department（4,6.25%）and the ICUs of neurosurgery department（4,6.25%）.Totally 60 incidents were associated with the contact transmission,34 incidents were associated with the hand hygiene of health care workers,21 incidents were associated with the contamination of bedside tables,and 17 incidents were associated with bed rails.CONCLUSION The contact transmission is dominant among the outbreak incidents of healthcare-associated infections in the ICU,which is associated with the hands of the health care workers and surroundings of the patients,therefore,it is an effective way to strengthen the hand hygiene and aseptic operation of the health care workers and focus on the disinfection of environment and object surfaces so as to reduce the incidence of the healthcare-associated infections in the ICUs.

关 键 词：重症监护病房 医院感染 暴发 

分 类 号：R197.323[医药卫生—卫生事业管理]