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目的了解重症医学病房(ICU)医院感染特点、病原菌分布及侵入性操作的感染情况,为控制感染和持续质量改进提供依据。方法采用目标性监测方法,收集2012年1月-2013年12月ICU710例患者发生医院感染、侵入性操作相关感染及常见病原菌分布情况资料,以患者平均病情严重程度(ASIS)评分调整发病率,采用Excel电子表格录入数据资料,对数据进行描述性统计分析。结果 710例患者中发生医院感染94例、感染例次97例、感染率为13.24%、感染例次率为13.66%;日感染率为15.06‰、日例次感染率为15.54‰,平均病情严重程度为3.09分,经调整后分别为4.87‰、5.03‰;2012年呼吸机相关性肺部感染率为21.28‰、中心静脉插管相关性血流感染率7.31‰、留置尿管相关性泌尿道感染率0.42‰,2013年感染率分别为7.73‰、2.29‰、0.29‰;两年共检出141株病原菌,其中革兰阴性杆菌94株,占66.67%。结论 ICU医院感染率高,主要为3种侵入性操作相关感染,其中以呼吸机相关肺部感染最高,应加强引起感染相关因素控制。
Objective To understand the characteristics of nosocomial infections, the distribution of pathogenic bacteria and the invasive operation in intensive care unit (ICU), so as to provide basis for infection control and continuous quality improvement. Methods Objective Surveillance methods were used to collect data on nosocomial infections and invasive operations in 710 ICU patients from January 2012 to December 2013. The prevalence of nosocomial infections and common pathogens were analyzed. The incidence of nosocomial infections was adjusted according to the patients’ mean severity of illness (ASIS) Use Excel spreadsheet to input data and descriptive statistical analysis of the data. Results Among the 710 patients, 94 were hospital nosocomial infections with 97 cases of infection, the infection rate was 13.24%, the infection rate was 13.66%, the daily infection rate was 15.06 ‰, the daily infection rate was 15.54 ‰ and the average severity was severe The degree of 3.09 points, after adjustment were 4.87 ‰, 5.3 ‰; 2012 lung-ventilator-related infection rate was 21.28 ‰, central venous catheter-related bloodstream infection rate was 7.31 ‰, indwelling catheter-related urinary tract The infection rate was 0.42 ‰. In 2013, the infection rates were 7.73 ‰, 2.29 ‰ and 0.29 ‰, respectively. 141 pathogens were detected in two years, of which 94 were gram-negative bacilli, accounting for 66.67%. Conclusion ICU hospital infection rate is high, mainly three kinds of invasive operation-related infections, of which ventilator-associated lung infection is the highest, should be strengthened to cause infection-related factors.