重症监护病房获得性感染的监测与预防  

Surveillance and Prevention on Acquired Infection at ICU

作　　者：顾克菊[1] 高云[2] 贾淑梅[1] 刘冰[1] 

机构地区：[1]第四军医大学西京医院,陕西西安710032 [2]解放军第三二三医院,陕西西安710054

出　　处：《实用护理杂志》2003年第1期48-49,共2页Journal of Practical Nursing

摘　　要：目的　探讨综合性医院ICU获得性感染的流行病学、致病菌分布及耐药情况 ,为医院感染的防治提供依据。方法　对 4个ICU 2 0 0 1年 4～ 9月收治的 796例患者进行了前瞻性调查。结果　感染发生率 2 0 0 % ( 15 9/ 796) ,发生 2例次以上感染者占 2 9 6% ( 47/ 15 9)。与留置尿管相关的泌尿道感染日发病率为 9 9‰ ,与使用呼吸机相关的肺部感染日发病率为 5 0 1‰ ,与气管切开相关的肺部感染日发病率为 85 9‰。感染部位占前 3位的是肺部感染5 0 0 % ( 10 4/ 2 0 8)、胃肠道感染 2 1 2 % ( 44 / 2 0 8)和泌尿道感染 16 3 % ( 3 4/ 2 0 8)。分离出 188株致病菌 ,仍以革兰氏阴性菌为主 ,占 65 4% ( 12 3 / 188)。居前 3位的是绿脓杆菌 2 6 1% ( 49/ 188) ,真菌 13 8% ( 2 6/ 188) ,不动杆菌12 2 % ( 2 3 / 188)。结论　ICU获得性感染发生率高 ,致病菌仍以革兰氏阴性菌为主 ,革兰氏阳性球菌及真菌有上升趋势 ,细菌耐药性升高 ,应建立ICU获得性感染监测制度 ,合理使用抗菌药物 。Objective\ To search for the epidemic causes of nosocomial infection (NI), distribution and drug resistance of pathogen at ICU. The study was carried out on 796 patients admitted from April and Sept. 2001. Results\ The overall incidence of nI was 20%; 47% of NI patients got infected more than twice. The daily incidence of urinary-catheter related urinary tract infection was 9.9%, respirator related lung infection 50.1% and tracheotomy related lung infection 85.9%.The three main types of NI were lower respiratory tract infection (50.0%), gastrointetestinal tract infection (21.1%) and urinary tract infection (12.2%).The leading microrganism cultured was gramnegative bacterium, about 65.4%. The other main three types were psudomonas aeruginosa (26.1%),fungi (13.8%) and acinetobacterspp ( 12.2% ). Conclusion\ The high incidence of NI was found in ICU. The leading microrganisms was gramnegative bacterium. The types of grampositive bacterium and fungi infection was on the rise. A very high frequence of drug resistance was found. It is advisable to set up the surveillance system, rational use of antibiotics and active prevention measures.

关 键 词：重症监护病房 获得性感染 监测 预防 

分 类 号：R181.3[医药卫生—流行病学]