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目的对重症监护病房(ICU)进行医院感染连续性目标性监测,探索有效控制ICU医院感染的方法。方法对2009-2012年在ICU住院超过48 h的628例患者进行医院感染目标性监测,2009年为回顾性调查,后三年为前瞻性调查。结果实施前瞻性目标性监测后,ICU感染率由2009年87.79‰显著降低到2010年40.34‰(χ2=13.70,P<0.01),由2011年37.82‰显著下降到2012年22.77‰(χ2=7.73,P<0.01);其中呼吸机相关性肺炎(VAP)感染率由2009年61.92‰下降到2010年36.33‰、2011年24.18‰和2012年14.94‰;导尿管相关性尿路感染(CAUTI)由2009年8.77‰下降到2010年4.48‰、2011年5.51‰、2012年2.93‰;中心静脉导管相关性血流感染(CLABSI)分别由2009年8.79‰下降到2010年7.42‰、2011年6.31‰、2012年2.56‰。结论通过连续性目标性监测评价管理措施的效果并持续改进,可有效地控制ICU医院感染。
Objective To monitor the continuity of nosocomial infections in intensive care unit (ICU) and explore ways to effectively control nosocomial infections in ICU. Methods Objective surveillance of nosocomial infections in 628 patients hospitalized in the ICU for more than 48 h from 2009 to 2012 was retrospectively reviewed in 2009 and prospectively followed up for the next three years. Results The ICU infection rate significantly decreased from 87.79 ‰ in 2009 to 40.34 ‰ in 2010 (χ2 = 13.70, P <0.01), significantly decreased from 37.82 ‰ in 2011 to 22.77 ‰ in 2012 (χ2 = 7.73 , P <0.01). The infection rate of ventilator-associated pneumonia (VAP) decreased from 61.92 ‰ in 2009 to 36.33 ‰ in 2010, 24.18 ‰ in 2011 and 14.94 ‰ in 2012, and the urinary catheter-associated urinary tract infection (CAUTI) From 8.77 ‰ in 2009 to 4.48 ‰ in 2011, 5.51 ‰ in 2011 and 2.93 ‰ in 2012. The CLABSI decreased from 8.79 ‰ in 2009 to 7.42 ‰ in 2010 and 6.31 ‰ in 2011 , 2.56 ‰ in 2012. Conclusions ICU nosocomial infections can be effectively controlled through continuous target monitoring to evaluate the effectiveness and continuous improvement of management measures.