2017-2019年某医院综合ICU医院感染目标监测分析

目的分析某医院综合重症医学科(ICU)医院感染目标性监测情况。方法对2017-2019年宁夏回族自治区人民医院ICU目标性监测数据,包括医院感染发病率、医院感染部位分布、三管使用及其相关感染、医院感染病原菌分布等进行回顾性分析。结果共监测ICU患者4953例,医院感染发病率为6.42%,医院感染例次发病率为8.46%;感染部位以呼吸系统为主占73.03%;泌尿道插管相关泌尿道感染(CAUTI)、血管导管相关血流感染(CRBSI)、呼吸机相关肺炎(VAP)感染发病率分别为1.50‰、2.46‰和13.66‰;检出病原菌356株,前三位依次为鲍氏不动杆菌、肺炎克雷伯菌和金黄色葡萄球菌。结论医院ICU医院感染发病率较高,感染部位以呼吸系统为主,分离病原菌以革兰阴性菌为主,总器械使用率高,提示临床应严格留置导管指征,对VAP等医院感染高危因素及时采取有效地预防措施,降低感染风险,保障患者安全。

Targeted surveillance of nosocomial infection in ICU of a hospital from 2017 to 2019

OBJECTIVE To analyze the status of targeted surveillance of nosocomial infection in intensive care unit(ICU)of a hospital.METHODS The data of targeted surveillance of nosocomial infection in ICU of People’s Hospital of Ningxia Hui Autonomous Region,including the incidence of nosocomial infection,nosocomial infection sites,utilization rates of three catheter and incidence of related infections as well as pathogens causing nosocomial infection,were retrospectively analyzed.RESULTS A total of 4953 ICU patients were under surveillance,the incidence of nosocomial infection was 6.42%,and the case-time infection rate was 8.46%.The patients with respiratory system infection accounted for 73.03%;the incidence rates of catheter-associated urinary tract infection(CAUTI),catheter-related bloodstream infection(CRBSI)and ventilator-associated pneumonia(VAP)were 1.50‰,2.46‰and 13.66‰,respectively.Totally 356 strains of pathogens were isolated;Acinetobacter baumannii,Klebsiella pneumoniae and Staphylococcus aureus ranked the top 3 species of pathogens.CONCLUSION The prevalence rate of nosocomial infection is high in the ICU,the respiratory system is the major infection site,the gram-negative bacteria are dominant among the isolated pathogens,and the utilization rate of instruments is high.It is necessary to carry out the catheterization based on strict catheter indwelling indications and take effective prevention measures according to the high risk factors for nosocomial infection such as VAP so as to reduce the risk of infection and safeguard the patients.