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目的 探讨急诊科重症患者医院感染的危险因素及预防措施.方法 调查分析2007年1月～2008年12月急诊科危重抢救患者就诊疾病、侵入性操作、医院感染率、医院感染危险因素、感染部位及感染菌群分布情况.结果 急诊科危重患者医院感染率为18.8%,以下呼吸道感染率为最高,占61.0%;医院感染危险因素为患者严重的基础疾病、多种侵入性操作,广谱抗菌药物和皮质激素的大量应用等;医院感染病原菌包括耐甲氧西林葡萄球菌(MRS)、肠球菌属、产超广谱β-内酰胺酶(ESBLs)细菌、铜绿假单胞菌和鲍氏不动杆菌、白色假丝酵母菌等耐药菌.结论 必须采取切实的管理措施,预防和降低急诊科患者医院感染率.“,”OBJECTIVE To explore the risk factors and the prevention measures of nosocomial infections in critical patients in emergency department.METHODS We reviewed the clinical materials of critical patients from Jan 2007 to Oct 2008 in our emergency department and analyzed the data of hospitalization diagnosis,invasive operation history,nosocomial infection ratio and risk factors,infection site and organism distribution.RESULTS The nosocomial infection ratio was 18.8%.The lower respiratory tract infection occurred most frequently(61.0 %).The potential risk factors were serious underlying disease,invasive operation,application of broad-spectrum antibiotics,application of glucocorticoid,etc.The pathogenic organism included MRSA,Enterococcus,ESBLs-producing bacteria,Pseudomonas aeruginosa,Acinetobacter spp,Candida albicans,etc.CONCLUSIONS Special attention should be paid to reduce the nosocomial infection in emergency department.