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目的分析某院重症监护病房发生医院感染的危险因素、易发部位及病原菌构成,为采取措施预防医院感染的发生提供科学依据。方法对浙江省平湖市第一人民医院2011年1月-2014年6月ICU收治的200例患者的病例资料进行回顾性调查,分析不同人群特征的患者的医院感染发生率,找出危险因素;统计医院感染易发部位及病原菌种类。结果该院ICU住院患者医院感染发生率为45%(90/200)。年龄≥60岁、有吸烟史、糖尿病、住院天数≥14 d、意识昏迷、使用呼吸机、留置尿管、留置胃管、气管插管、气管切开的ICU住院患者医院感染发生率显著升高(P<0.05);ICU医院感染部位以下呼吸道为首位(55.56%),其次为泌尿道感染(15.56%)、上呼吸道感染(12.22%);ICU医院感染病原菌前三位分别为铜绿假单胞菌、肺炎克雷伯菌和白假丝酵母菌,所占比例分别为27.78%、15.56%和12.22%。结论高龄、伴有基础疾病、住院时间长、创伤性操作是ICU住院患者发生医院感染的危险因素。护理中,应特别注意预防下呼吸道感染,针对感染病原菌合理应用抗菌药物。
Objective To analyze the risk factors of nosocomial infection in hospital intensive care unit (ICU) and the components of pathogens that are prone to develop and provide scientific basis for the prevention of nosocomial infections. Methods The data of 200 cases admitted to the First People ’s Hospital of Pinghu City, Zhejiang Province from January 2011 to June 2014 were retrospectively analyzed to analyze the prevalence of nosocomial infections in different population characteristics and identify the risk factors. Statistical hospital infection prone areas and pathogenic bacteria species. Results The incidence of nosocomial infection in ICU hospital was 45% (90/200). The incidence of nosocomial infection in hospitalized patients with ICU ≥ 60 years, smoking history, diabetes mellitus, hospital stay ≥ 14 days, conscious unconsciousness, ventilator, indwelling catheter, indwelling gastric tube, tracheal intubation and tracheostomy were significantly higher (P <0.05). The most common respiratory tract infection was ICU (55.56%), followed by urinary tract infection (15.56%) and upper respiratory tract infection (12.22%). Klebsiella pneumoniae and Candida albicans, accounting for 27.78%, 15.56% and 12.22%, respectively. Conclusion Elderly patients with underlying diseases, long hospital stay and traumatic operations are the risk factors of nosocomial infection in inpatients with ICU. Care, special attention should be paid to prevent lower respiratory tract infection, rational use of antimicrobial agents against pathogens.