2017—2020年某医院神经外科重症监护病房“三管”感染目标性监测  

Targeted surveillance of"three-catheters"infection in neurosurgery ICU of a hospital from 2017 to 2020

作　　者：张蕾[1] 富小凤 贾佳[1] ZHANG Lei;FU Xiao-feng;JIA Jia(Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院,上海200040

出　　处：《中国消毒学杂志》2023年第4期272-275,共4页Chinese Journal of Disinfection

基　　金：上海市周良辅医学发展基金资助(XM00025-2020-4)。

摘　　要：目的 分析某医院神经外科重症监护病房(ICU)“三管”感染目标性监测情况。方法 对2017—2020年入住某综合医院神经外科ICU且入住时长≥48 h的所有患者进行“三管”目标性监测,对医院感染发病率、“三管”的使用情况、“三管”相关感染发病率、病原菌分布等进行统计学分析。结果 2017—2020年共监测神经外科ICU患者5 963例,发生医院感染110例、152例次,医院感染发病率为1.84%,例次发病率为2.55%。呼吸机、中心静脉导管、导尿管插管的使用率分别为30.55%、27.17%、69.16%,VAP、CLABSI、CAUTI的发病率分别为5.67‰、0.77‰、1.38‰,使用率和感染发病率均无相关性。共分离非重复病原菌78株,以革兰阴性菌为主(65.38%),鲍曼不动杆菌、肺炎克雷伯菌和铜绿假单胞菌是VAP的主要病原菌,葡萄球菌是CLABSI的主要病原菌,肠球菌和大肠埃希菌是CAUTI的主要病原菌。结论 应持续加强神经外科ICU的“三管”感染目标性监测,并定期分析、反馈和查找高危因素,及时采取针对性干预措施,有效降低相关感染的发生。Objective To analyze the targeted surveillance of"three-catheters"infection in neurosurgery ICU of a hospital.Methods The"three-catheters"targeted surveillance was conducted on all patients who were admitted to the neurosurgery ICU of a general hospital from 2017 to 2020 and the length of stay was≥48 h.The incidence of nosocomial infection,the usage of"three-catheters",the incidence of"three-catheters"related infections and the distribution of pathogens were analyzed statistically.Results From 2017 to 2020,a total of 5963 cases from neurosurgery ICU were monitored,and 110 patients and 152 cases of nosocomial infection occured.The incidence rate of nosocomial infection was 1.84%,and the incidence case rate was 2.55%.The usage rates of ventilator,central vein catheter and urethral catheter were 30.55%,27.17%and 69.16%,respectively,and the incidence rates of VAP,CLABSI and CAUTI were 5.67%o,0.77%o,1.38%o,respectively,and there was no correlation between usage rate and infection rate.A total of 78 strains of non-repetitive pathogens were isolated,which were mainly gram-negative bacteria(65.38%).Acinetobacter baumanni,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens for VAP.Staphylococcus was the main pathogen for CLABSI.Enterococcus and Escherichia coli were the main pathogens for CAUTI.Conclusions It is necessary to continue to strengthen the targeted surveillance of"three-catheters"infection in neurosurgery ICU,and high-risk factors should be regularly analyzed,feedbacked and found.Targeted intervention measures should be taken in time to effectively reduce the occurrence of infections.

关 键 词：神经外科 重症监护病房 目标性监测 导管相关感染 病原菌 

分 类 号：R197.3[医药卫生—卫生事业管理]