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目的分析和探讨非导管相关性感染在重症监护病房(ICU)医院感染中的重要性。方法对2011年1月-2013年12月进入综合ICU的所有患者进行前瞻性目标监测,并将医院感染病例按感染类型进行分组分析。结果共监测5 364例患者,发生医院感染455例(616例次),例次率为11.5%。其中导管相关性感染例次数、构成比均呈逐年下降趋势,而非导管相关性感染例次数和构成比均呈逐年上升趋势。发生医院感染的455例患者中,混合感染组患者住ICU时间>导管相关性感染组>非导管相关性感染组(P<0.05);混合感染组住院时间高于导管相关性感染组和非导管相关性感染组(P<0.05);导管相关性感染组粗死亡率高于非导管相关性感染组和混合感染组(P<0.017)。结论导管相关性感染会延长ICU患者住院时间,增加其死亡风险,仍然是ICU医院感染目标性监测的重点。非导管相关性感染在ICU医院感染中所占比重越来越高,也应予以足够重视。
Objective To analyze and explore the importance of non-duct-related infections in intensive care unit (ICU) nosocomial infections. Methods All patients admitted to the ICU from January 2011 to December 2013 were prospectively monitored, and hospital infections were grouped by type of infection. Results A total of 5 364 patients were monitored. 455 cases (616 cases) of nosocomial infections were reported. The case-time rate was 11.5%. Among them, the number of catheter-related infections and the constituent ratio of them all showed a declining trend year by year, while those of non-catheter-related infections increased year by year and proportionately. Among the 455 patients with nosocomial infections, ICU time was longer in patients with mixed infection than in catheter-related infections> non-catheter-related infections (P <0.05). The hospital stay time in mixed infection group was higher than that in catheter-related infection group and non- (P <0.05). The crude mortality rate in catheter-related infection group was higher than that in non-catheter-related infection group and mixed infection group (P <0.017). Conclusions Catheter-associated infections may prolong the length of hospital stay and increase the risk of death in ICU patients and remain the focus of targeted surveillance of ICU hospital infections. Non-duct-related infections are becoming more prevalent in ICU nosocomial infections and should be given adequate attention.