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目的:研究目标性监测在ICU医院感染中的应用情况,了解ICU患者医院感染的特点及病原菌分布,为医院感染预防和控制提供依据。方法:研究对象为2013年1月~2014年1月湖州市第一人民医院ICU收治的928例患者。对其进行导管相关性感染的检测,包括呼吸机使用率、中心静脉插管率、泌尿道插管率以及相关感染发生率等,对目前存在的问题进行分析,并实施持续性质量改进。结果:928例患者中发生医院感染的112例,占12.1%;日感染率为1.1%,呼吸机相关性肺炎日感染发生率为1.4%,尿管相关尿路感染日感染发生率为0.2%,导管相关血液感染日感染发生率为0.1%。医院感染以肺部感染为主,病原菌以革兰阴性菌为主,主要病原菌包括肺炎克雷伯菌、鲍氏不动杆菌和铜绿假单胞菌等。结论:目标性监测用于医院ICU能够有效地对患者地医院感染发生情况进行动态观察,为医院感染管理改进提供必要依据。
Objective: To study the application of target monitoring in ICU nosocomial infection, understand the characteristics of nosocomial infection and distribution of pathogens in ICU patients, and provide basis for prevention and control of nosocomial infection. Methods: The study population was 928 patients admitted to ICU of Huzhou First People’s Hospital from January 2013 to January 2014. Conduct catheter-related infection testing, including ventilator usage, central venous catheterization, urinary catheterization, and related infections, to analyze current issues and implement continuous quality improvement. Results: Of the 928 patients, 112 (12.1%) had nosocomial infection, the daily infection rate was 1.1%, the incidence of ventilator-associated pneumonia was 1.4% and the incidence of urinary tract-related urinary tract infection was 0.2% The incidence of catheter-related bloodstream infection was 0.1%. Nosocomial infection is mainly caused by pulmonary infection. Gram-negative bacteria are the main pathogens. The main pathogens include Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa. Conclusion: Objective monitoring can be used to effectively monitor hospital nosocomial infections in hospitals and provide the necessary evidence for the improvement of hospital infection management.