2017—2022年北京市某三级医院ICU医院感染特征分析  

Analysis on the characteristics of nosocomial infection in ICU in a tertiary hospital in Beijing,2017-2022

作　　者：姜雪 赵会娟 杨立霞 杜世英 袁伟静 JIANG Xue;ZHAO Huijuan;YANG Lixia;DU Shiying;YUANWeijing(Beijing Shunyi Hospital,Beijing 101300,China;Business School of Guilin University of Technology;Fuwai Hospital,Chinese Academy of Medical Sciences)

机构地区：[1]北京市顺义区医院,北京101300 [2]桂林理工大学商学院 [3]中国医学科学院阜外医院

出　　处：《热带病与寄生虫学》2023年第6期353-356,共4页Journal of Tropical Diseases and Parasitology

摘　　要：目的 了解北京市某三级医院重症监护病房(intensive care units, ICU)医院感染特征及变化趋势,为精准制定医院感染防控措施提供依据。方法 收集2017—2022年北京市医院感染监控管理系统报告的某三级医院ICU医院感染病例的临床资料,分析医院感染发病率、日感染率随年份的变化趋势,以及医院感染病例的年龄、感染部位、病原菌种类等特征。结果 2017—2022年共监测ICU患者3 001例,发生医院感染160例,195例·次,平均发病率为5.33%,2017—2022年发病率分别为4.61%(20/434)、8.02%(38/474)、7.16%(34/475)、4.90%(21/429)、3.29%(24/730)和5.01%(23/459),总体呈下降趋势(Z=2.061,P<0.05)。2017—2022年平均日感染率为0.55%(160/28 987)。ICU医院感染病例年龄中位数为70.0(57.5,80.0)岁,以60岁及以上为主(占72.50%,116/160)。195例·次医院感染中,感染部位以呼吸系统居首(占46.67%,91/195),其次为血液系统(占33.85%,66/195)。医院感染患者分离出的160株病原菌中排名前3位的分别为肺炎克雷伯菌(占16.88%,27/160)、鲍曼不动杆菌(占14.38%,23/160)和铜绿假单胞菌(占13.75%,22/160)。结论 2017—2022年该医院ICU的医院感染发病率较低,且呈下降趋势。感染主要发生在老年人群,呼吸道感染是其主要途径,导致感染的病原菌以革兰氏阴性菌为主。提示应关注ICU发生医院感染的重点人群,落实医院感染防控措施,强化监测,降低医院感染发生风险。Objective To understand the characteristics and changing trend of nosocomial infection in the intensive care unit(ICU)in a tertiary hospital in Beijing for evidence to formulate prevention and control measures for nosocomi-al infection.Methods The clinical data of all nosocomial infection cases reported by a tertiary hospital in Beijing from 2017 to 2022 was derived through the Beijing Nosocomial Infection Surveillance and Management System,and analyzed pertinent to the changing trends by year of nosocomial infection proportion,incidence rate,age group,infec-tion site and pathogens responsible for the infection.Results A total of 3001 ICU patients were monitored,and 160 cases(195 times)of nosocomial infection occurred in 2017-2022,with overall nosocomial infection rate of 5.33%.The in-fection rates from 2017 to 2022 were 4.61%(20/434),8.02%(38/474),7.16%(34/475),4.90%(21/429),3.29%(24/730)and 5.01%(23/459),respectively,which indicated a decreasing trend(Z=2.061,P<0.05).The average daily nosocomial infection incidence was 0.55%(160/28987)from 2017 to 2022.The median age for the ICU infections was 70.0(57.5,80.0)years,and the infection most occurred in patients aged 60 years or older(72.50%,116/160).The most common in-fection site was in respiratory system(46.67%,91/195),followed by blood system(33.85%,66/195).The top three pathogens responsible for the nosocomial infection were involved in Klebsiella Pneumoniae(16.88%,27/160),Acineto-bacter baumannii(14.38%,23/160)and Pseudomonas aeruginosa(13.75%,22/160).Conclusion The incidence of nosocomial infections of ICU of this hospital was lower,and the incidence tended to decrease from 2017 to 2022.The infections mainly occurred in the elderly population,and respiratory infections are the main pathway.Gram negative bacteria are the major pathogens causing the infections.The findings suggest that attention should be paid to the key populations for nosocomial infections in ICU through implementation of the prevention and control measures and strengthening targeted surveill

关 键 词：重症监护病房 医院感染 病原菌 

分 类 号：R181.32[医药卫生—流行病学]