摘要
目的通过开展ICU目标性监测,提高感染预防控制措施的执行力,降低医院感染发生率。方法按照相关规范对2011年入住ICU的患者进行监测,运用MINKE软件系统对监测资料进行汇总分析,利用Stata10.0版软件对监测数据进行统计处理。结果 2011年入住ICU患者65450例,发生医院感染5955例、9021例次,患者平均病情严重程度3.50,调整后的日感染率为4.13‰,调整例次日感染率6.25‰;在不同类型ICU中以外科ICU感染率最高,综合ICU次之,ICU医院感染的主要部位为下呼吸道、尿路和血液感染,分别占70.87%、13.76%和9.46%,其中呼吸机相关性肺炎、导管相关性尿路感染和导管相关性血流感染,分别占34.24%、9.63%、5.76%;ICU医院感染以革兰阴性菌多见,其中居前4位的病原菌为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌及大肠埃希菌。结论导管相关性感染将是ICU监测及干预重点,应将各类感染预防措施纳入监测目标中,耐药菌的监测应进一步深入到个体动态,真正从结果监测过渡到过程监测,同时应提高ICU医护人员的感染预防与控制意识,在日常工作中将预防控制措施落实到位是开展目标性监测的重要目的。
OBJECTIVE To develop the targeted monitoring in the ICU to improve the execution of the prevention and control measures for infection control so as to reduce the incidence of the nosocomial infections.METHODS In accordance with the standards for nosocomial infection surveillance,the patients who admitted to the ICU in 2011 were monitored,MINKE was employed to sum up and analyze the the monitoring data.The statistics were processed by using the Stata10.0 software.RESULTS Of totally 65,450 hospitalized patients in the ICU in 2011,the nosocomial infections occurred in 5955 cases（9021 case-times）.The average severity of illness was 3.50,the daily infection rate after the adjustment was 4.13‰,the adjusted case-time daily infection rate was 6.25‰.Among various types of ICUs,the infection rate was highest in the surgical ICU,followed by the general ICU.The lower respiratory tract,urinary tract,and the blood were the main infection sites,accounting for 70.87%,13.76%,and 9.46%,respectively,among which the constituent ratios of the ventilator-associated pneumonia,CAUTI,and CRBSI were 34.24%,9.63%,and 5.76%,respectively.The gram-negative bacteria were the most common pathogens causing nosocomial infections in ICU,among which the top four species were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli.CONCLUSION It is of the key point of the monitoring and interventions to the catheter-related infections in ICU.A varieties of prevention measures should be incorporated into the monitoring target,and the surveillance of drug resistant bacteria should further step to the individual dynamic,having made the surveillance shift from the result surveillance to the process surveillance.It is necessary to improve the awareness of the ICU medical staff of the infection prevention,and to make the prevention and control measures put in place which is the significant objective of the targeted monitoring.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第21期4712-4714,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
目标性监测
医院感染
Intensive care unit
Targeted monitoring
Nosocomial infection
作者简介
通讯作者：周宏，E-mail：Zhouhong631008@163．com
