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目的探讨重症监护病房(ICU)血管导管相关感染发生情况、影响因素、病原菌分布及抗菌治疗方式等,为相关临床研究提供参考依据。方法选取2014年1月-2015年10月医院ICU临床收治的重症患者252例为研究对象,针对患者的感染情况、导致感染的影响因素、感染的病原菌分布、药敏试验结果及抗菌治疗效果进行调查研究。结果 ICU 252例患者中,发生血管导管感染44例,感染率为17.46%;年龄、格拉斯哥昏迷评分、住院时间、合并症种类、昏迷时间和感染史等因素是导致患者感染的影响因素;感染患者共检测出病原菌51株,其中革兰阴性菌36株占70.59%,革兰阳性菌11株占21.57%,真菌4株占7.84%;检出的主要革兰阴性菌对左氧氟沙星、氨苄西林的耐药率为100.00%,对哌拉西林、他唑巴坦的耐药率为0,检出的主要革兰阳性菌对左氧氟沙星、庆大霉素的耐药率为100.00%,对利福平、万古霉素的耐药率为0。结论 ICU血管导管相关感染情况较为严重,年龄、格拉斯哥昏迷评分、住院时间、合并症种类、昏迷时间和感染史等因素是导致患者感染的影响因素,在临床治疗过程中应根据患者的药敏试验结果实施针对性的治疗,可以显著提升临床综合疗效。
Objective To investigate the incidence of vascular catheter-related infections in ICU and its influencing factors, distribution of pathogens, antibacterial therapy and so on, so as to provide references for related clinical studies. Methods A total of 252 critically ill patients admitted to the hospital ICU from January 2014 to October 2015 were selected as research objects. According to the patients’ infection status, the influencing factors of infection, the distribution of pathogens, the results of drug sensitivity test and antibacterial treatment Research. Results Among the 252 patients in ICU, 44 cases were infected with vascular catheter and the infection rate was 17.46%. Factors such as age, Glasgow coma score, length of stay, comorbidities, coma time and infection history were the influencing factors of infection. Infected patients A total of 51 strains of pathogens were detected, of which 36 strains accounted for 70.59% of Gram-negative bacteria, 11 strains of Gram-positive bacteria accounted for 21.57% and 4 strains of fungi accounted for 7.84%. The main Gram-negative bacteria detected were resistant to levofloxacin and ampicillin The drug resistance rate was 100.00%. The resistance rate to piperacillin and tazobactam was 0. The resistance rate of main Gram-positive bacteria to levofloxacin and gentamicin was 100.00% The rate of vancomycin resistance was zero. CONCLUSIONS: The incidence of vascular catheter-related infections in ICU is more serious. Factors such as age, Glasgow coma score, length of hospital stay, type of comorbidities, coma time and infection history are the influencing factors of patient infection. In the course of clinical treatment, Results The implementation of targeted treatment can significantly improve the clinical efficacy.