ICU医院感染目标性监测及危险因素分析  

Analysis of Target Monitoring and Risk Factors of Nosocomical Infection in ICU

作　　者：李艳萍[1] 乔甫[2] 陆婷婷[2] 文佳[1] 马春华[1] 赵跃[1] 张秀玲[1] 邹艳[1] 

机构地区：[1]四川省绵阳市中心医院医院感染管理科,四川绵阳621000 [2]四川大学华西医院,四川成都610041

出　　处：《医学临床研究》2015年第10期1876-1878,共3页Journal of Clinical Research

基　　金：2014中华医院感染控制研究基金ZHYG2014-0024

摘　　要：【目的】探讨重症监护病房（ICU）医院感染目标性监测及危险因素，针对性地提出控制医院感染的预防措施。【方法】 选择2013年1月1日至12月31日本院ICU收治的1289例患者，计算患者平均病情严重程度（ASIS）、调整医院感染发生率、侵入性操作相关感染率等指标，分析发生感染的高危因素。【结果】ICU医院感染66例（5.12%），日感染发病率为10.36‰，调整后日感染发病率为1.98‰，各季度医院感染发病呈下降趋势。病情的平均严重程度2.58，根据病情严重程度调整后医院感染发病率为1.98%。最常见的感染是侵入性操作相关的感染：呼吸机相关性肺炎、血管导管相关性血流感染，导尿管相关性泌尿道感染。病原菌主要以革兰阴性菌为主，共计183株（90.59%）；革兰阳性菌19株（9.41%）。【结论】 ICU医院感染率较高，主要为3种侵入性操作相关感染；目标性监测能及时准确获得ICU医院感染动态变化信息，制定干预措施，降低ICU医院感染发生率。[Objective] To investigate the target monitoring and risk factors of nosocomial infection in ICU, and to put forward the preventive measures specifically to control nosocomial infection. [Methods] 1,289 patients in ICU admitted to the hospital from 1st January 2013 to 31st December 2013 were chosen to calculate the average severity of illness （ASIS）, the adjusted incidence of nosocomial infection, the invasive operation related infections and other relevant indicators. High risk factors for infection were analyzed . [Results] ICU patients with nosocomial infection covered 66 cases （5.12%）, the daily incidence of infection rate was1.036% . After adjustment the infection rate was 1.98‰. The quarterly hospital infection showed a downward trend. The average severity of illness was 2.58, and the incidence of nosocomial infection was 1.98% after adjustment of the severity of the disease,;The most common infections were those related invasive operation ： ventilator associated with pneumonia, vascular catheter related bloodstream infection , and catheter related urinary tract infection. The pathogens were mainly gram negative bacteria, with a total of 183 strains （90.59%）,and gram positive bacteria took 19 （9.41%）. [Conclusion] The infection rate of ICU was so high mainly because of 3 kinds of invasive operation related infections; Dynamic changes in ICU infection information can timely be accurated through the access of target monitoring so as to develop interventions to reduce the incidence of nosocomial infection in ICU.

关 键 词：重症监护病房 交叉感染/预防和控制 危险因素 

分 类 号：R63[医药卫生—外科学]