2019—2021年某三甲医院ICU医院感染目标性监测  

Targeted monitoring of healthcare-associated infection in intensive care unit in a tertiary first-class hospital,2019-2021

作　　者：袁倩倩 秦微 周志剑 王娜 YUAN Qian-qian;QIN Wei;ZHOU Zhi-jian;WANG Na(Healthcare-associated Infection Management Office,People’s Hospital of Xinjiang Bayingolin Mongolian Autonomous Prefecture,Korla 841000,China;Department of Critical Care Medicine,People’s Hospital of Xinjiang Bayingolin Mongolian Autonomous Prefecture,Korla 841000,China;Department of Laboratory Medicine,People’s Hospital of Xinjiang Bayingolin Mongolian Autonomous Prefecture,Korla 841000,China)

机构地区：[1]新疆巴音郭楞蒙古自治州人民医院院内感染管理办公室,新疆库尔勒841000 [2]新疆巴音郭楞蒙古自治州人民医院重症医学科,新疆库尔勒841000 [3]新疆巴音郭楞蒙古自治州人民医院医学检验科,新疆库尔勒841000

出　　处：《中国感染控制杂志》2024年第4期508-513,共6页Chinese Journal of Infection Control

基　　金：巴音郭楞蒙古自治州人民医院院级科研项目(BHS201919)。

摘　　要：目的了解重症监护病房(ICU)医院感染与器械相关感染情况,为医院感染管理提供科学依据。方法收集2019年1月—2021年12月某三甲医院ICU住院患者医院感染监测数据并进行统计学分析。结果共监测2302例患者,发生医院感染120例(138例次),医院感染发病率为5.21%,发病例次率为5.99%。2019—2021年各年度医院感染发病率、发病例次率比较,差异均无统计学意义(均P>0.05)。医院感染部位以下呼吸道(96例次,69.57%)为主,其次是泌尿道(28例次,20.29%)和血液(6例次,4.35%)。共分离病原菌125株,以革兰阴性菌为主,占比74.40%。中央导管相关血流感染(CRBSI)、导尿管相关尿路感染(CAUTI)、呼吸机相关肺炎(VAP)日发病率依次为0.34‰、1.47‰、8.65‰,三年间器械相关感染发病率下降,VAP下降明显(均P<0.05)。非器械相关的医院获得性感染中肺部感染占比由23.53%上升至46.00%,差异具有统计学意义(P<0.05)。结论连续三年目标性监测显示,器械相关感染发病率下降,但非器械感染发病率升高。医院感染管理应增加监测非机械通气患者医院感染防控措施的落实情况,从而整体降低ICU医院感染发病率。Objective To understand the healthcare-associated infection(HAI)and device-associated infection in the intensive care units(ICU),and provide scientific basis for HAI management.Methods HAI monitoring data of patients in ICU in a tertiary first-class hospital from January 2019 to December 2021 were collected and conducted statistical analysis.Results A total of 2302 patients were monitored,and 120 patients(138 cases)had HAI.Incidence and cases incidence of HAI were 5.21%and 5.99%respectively.There were no statistically significant differences in incidence of HAI and case incidence of HAI in 2019-2021(all P>0.05).The main HAI site was lower respiratory tract(n=96 cases,69.57%),followed by the urinary tract(n=28 cases,20.29%)and bloodstream(n=6 cases,4.35%).A total of 125 strains of pathogens were isolated,with Gram-negative bacteria being the main strain,accounting for 74.40%.The incidence of central catheter-related bloodstream infection(CRBSI),catheter-associated urinary tract infection(CAUTI),and ventilator-associated pneumonia(VAP)were 0.34‰,1.47‰,and 8.65‰,respectively.Over the past three years,the incidence of device-associated infection decreased and VAP decreased significantly(both P<0.05).Among healthcare-associated non-device-associated infection,the proportion of pulmonary infection increased from 23.53%to 46.00%,with a statistically significant difference(P<0.05).Conclusion Three consecutive years of targeted monitoring showed that the incidence of catheter-associated infection decreased,but the incidence of non-device-associated infection increased.HAI management should strength the monitoring of the implementation of HAI prevention and control measures for non-mechanically ventilated patients,so as to reduce the overall incidence of HAI in ICU.

关 键 词：目标性监测 医院感染 器械相关感染 非器械感染 重症监护病房 

分 类 号：R181.32[医药卫生—流行病学]