2015-2017年上海市某区综合ICU器械相关感染现状分析  

Current status of device-related infection in comprehensive ICU of a district of Shanghai in 2015-2017

作　　者：刘程琳 袁艳玲[2] 翁晓芳[2] 谭军 王剑云 LIU Cheng-lin;YUAN Yan-ling;WENG Xiao-fang;TAN Jun;WANG Jian-yun(Jiangxi Medical College,Nanchang University,Nanchang,Jiangxi 330006,China)

机构地区：[1]南昌大学江西医学院公共卫生学院,江西南昌330006 [2]上海市第一人民医院宝山分院医院感染管理科,上海200940

出　　处：《中华医院感染学杂志》2018年第18期2778-2782,共5页Chinese Journal of Nosocomiology

摘　　要：目的了解上海市某区综合ICU器械相关感染发生情况,为制定具有针对性的防控措施提供参考依据。方法采用回顾性分析,对2015-2017年5家医院综合ICU医院感染目标性监测资料进行调查收集,使用SPSS21.0软件对数据进行分析,描述综合ICU患者的医院感染情况和器械相关感染发生情况。结果共4788例ICU患者纳入研究,住院总日数50418d,发生医院感染434例、510例次,医院感染发病率9.06%、日感染发病率为10.12‰,调整日感染发病率4.50‰;医院感染部位以呼吸系统为主,占71.76%;器械相关感染共221例次,占医院感染的43.33%,连续三年占比逐年下降(χ~2=24.44,P<0.001);器械相关感染发病率分别为呼吸机相关肺炎6.01‰、导尿管相关尿路感染1.93‰、中央导管相关血流感染0.68‰,以呼吸机相关肺炎发病率最高;器械相关感染患者共检出病原菌335株,以革兰阴性菌为主占67.16%,其次为革兰阳性菌占19.10%,最常见的病原菌为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌。结论器械相关感染仍是ICU医院感染的重点,应持续开展ICU医院感染目标性监测,继续加强和完善医院感染信息化建设。OBJECTIVE To investigate the prevalence of device-related infection in comprehensive ICU of a district of Shanghai so as to put forward the targeted prevention and control measures.METHODS By means of retrospective survey,the data of targeted surveillance of nosocomial infections were collected from comprehensive ICUs of 5 hospitals from 2015 to 2017,the statistical analysis was performed by using SPSS21.0 software,and the incidence of nosocomial infections and device-related infection in the ICU patients was analyzed.RESULTS Totally 4788 patients were enrolled in the study,with the total hospitalization duration 50418 days;434（510 case-times）patients had nosocomial infections,the incidence rate of nosocomial infections was 9.06%,the daily infection rate was 10.12‰,and the adjusted daily infection rate was 4.50‰.The patients with respiratory system infection were dominant among the patients with nosocomial infection,accounting for 71.76%;totally 221 case-times of patients had the device-related infection,accounting for 43.33% among the patients with nosocomial infections,and the percentage showed downward trend in the three consecutive years（χ2=4.44,P〈0.001）.Among the patients with device-related infection,the incidence rate of ventilator-related pneumonia（VAP）was 6.01‰,the incidence rate of urinary catheter-related urinary tract infection was 1.93‰,the incidence rate of central catheter-related bloodstream infection was 0.68‰,and the incidence rate of VAP was the highest.A total of 335 strains of pathogens were isolated from the patients with the device-related infection,67.16% of which were gram-negative bacteria,and 19.10% were gram-positive bacteria;Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii were the predominant species of pathogens.CONCLUSIONThe patients with device-related infection are dominant among the patients with nosocomial infections in the ICU.It is necessary to continuously conduct the targeted surveillance of nosocomial infect

关 键 词：重症监护病房 医院感染 器械相关感染 回顾性分析 

分 类 号：R183[医药卫生—流行病学]