2020-2022年某市15所综合性医院ICU医院感染目标性监测结果报告  

Report of targeted monitoring of nosocomial infections among ICU patients of 15 general hospitals in a city from 2020 to 2022

作　　者：肖瑾瑛 刘冬冬 彭莲华 黄玲 郭小平 戴恩龙 XIAO Jin-ying;LIU Dong-dong;PENG Lian-hua;HUANG Ling;GUO Xiao-ping;DAI En-long(Jinggangshan University Affiliated Hospital(Ji'an Hospital Infection Management Quality Control Center),Ji'an,Jiangxi 343000,China;不详)

机构地区：[1]井冈山大学附属医院医院感染预防与控制科(吉安市医院感染管理质量控制中心),江西吉安343000 [2]井冈山大学附属医院心胸大血管外科(吉安市介入治疗临床医学研究中心),江西吉安343000 [3]井冈山大学附属医院检验科,江西吉安343000

出　　处：《中华医院感染学杂志》2024年第22期3492-3497,共6页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(8166020257);江西省教育厅科技一般基金资助项目(GJJ211019);吉安市科技计划基金资助项目(20211-115559)。

摘　　要：目的分析2020-2022年某市15所综合性医院重症医学科(ICU)医院感染现况和流行病学特征。方法收集2020年1月-2022年12月江西省吉安市15所综合性医院综合ICU住院患者的医院感染监测数据。结果共监测ICU住院患者15034例次,发生医院感染611例、693例次,医院感染发病率、例次发病率分别为4.06%、4.61%;感染部位呼吸系统(65.80%)占首位;器械相关感染占比57.58%,其中导尿管相关尿路感染(CAUTI)、导管相关血流感染(CRBSI)、呼吸机相关肺炎(VAP)发病率分别为2.03‰、0.32‰和6.55‰;病原菌主要以革兰阴性菌为主(78.07%);多药耐药菌(MDRO)以耐碳青霉烯类鲍氏不动杆菌居多(80.65%)。不同年份综合ICU医院感染(例次)发病率、泌尿系统部位感染率、VAP和CAUTI发病率随年份增加呈下降趋势,但在不同等级医疗机构上,三级医院医院感染(例次)发病率[5.25%(6.01%)]、CRBSI发病率(0.69‰)、VAP发病率(9.34‰)、CAUTI发病率(4.23‰)、革兰阴性菌(81.66%)和MDRO检出率(65.33%)均高于二级医院[分别为3.50%(3.94%)、0.07‰、4.22‰、0.92‰、72.61%、46.96%],差异均有统计学意义(均P<0.05)。结论吉安市综合ICU医院感染发病率处于较低水平,但三级医院综合ICU需高度关注器械感染和MDRO管理,同时加强医院感染防控力度。OBJECTIVE To investigate the prevalence and epidemiological characteristics of nosocomial infections in critical care medicine departments of 15 general hospitals in a city from 2020 to 2022.METHODS The monitoring data of nosocomial infections were collected from the patients who were hospitalized in the general ICUs of 15 general hospitals in Ji′an city,Jiangxi Province from Jan.2020 to Dec.2022.RESULTS A total of 15,034 case-times of hospitalized patients of ICU were monitored,693(611 cases)of which had nosocomial infections,the incidence of nosocomial infection was 4.06%,and the case-time infection rate was 4.61%.The patients who had respiratory system infections ranked the first place among the patients with nosocomial infections.The patients who had instrument-associated infections accounted for 57.58%;the incidence rates of catheter-associated urinary tract infections(CAUTI),catheter-related bloodstream infections(CRBSI)and ventilator-associated pneumonia(VAP)were 2.03‰,0.32‰and 6.55‰,respectively.Gram-negative bacteria were dominant among the pathogens,accounting for 78.07%.Carbapenem-resistant Acinetobacter baumannii was the predominant multidrug-resistant organism(MDRO),accounting for 80.65%.The incidence(case-time infection rate)of nosocomial infections,incidence of infections of urinary system,VAP and CAUTI showed downward trends with the increasing years.As compared with the medical institutions in different grades,the incidence(case-time infection rate)of nosocomial infections,incidence of CRBSI,incidence of VAP and incidence of CAUTI of the tertiary hospitals were respectively 5.25%(6.01%),0.69‰,9.34‰and 4.23‰,higher than 3.50%(3.94%),0.07‰,4.22‰and 0.92‰of the secondary hospitals;the isolation rates of gram-negative bacteria and MDRO of the tertiary hospitals were respectively 81.66%and 65.33%,higher than 72.61%and 46.96%of the secondary hospitals(all P<0.05).CONCLUSION The incidence of nosocomial infection is low in the general ICUs in Ji′an city,however,it is necessary for t

关 键 词：医院感染 目标性监测 器械相关感染 多药耐药菌管理 重症医学科 

分 类 号：R192[医药卫生—卫生事业管理]