摘要
目的 探讨综合医院重症监护病房(ICU)医院感染目标性监测的结果。方法 选择郑州大学第一附属医院2019年11月1日至2022年10月31日ICU目标性监测患者51 126例进行研究,回顾性收集感染相关资料,从不同ICU科室患者、不同感染部位、不同导管相关性感染、不同感染病原菌分布等方面进行总结分析。结果 共监测发现医院感染1133例、1183例次,感染率和感染例次率分别为2.22%(1 133/51 126)和2.31%(1183/51 126)。不同科室ICU患者的医院感染率和感染例次率比较,差异有统计学意义(χ^(2)=291.697,P<0.001;χ^(2)=302.172,P<0.001),其中神经ICU医院感染率和感染例次率最高,为3.82%(174/4 553)和4.06%(185/4 553)。ICU器械相关性感染目标性监测分析中,使用呼吸机、中心静脉插管和导尿管插管患者的感染例次率和日感染例次率比较,差异有统计学意义(χ^(2)=98.068,P<0.001;χ^(2)=22.726,P<0.001),其中以使用呼吸机ICU患者最高,分别为2.25%(131/8 226)和0.351‰(131/374 285)。患者感染部位标本共检出病原菌1650株,其中以革兰阴性菌(62.97%)和革兰阳性菌(28.00%)为主,真菌占比最低(9.03%)。结论 综合医院ICU医院感染的目标性监测可为医院感染防控提供参考,需加强神经ICU、综合ICU等重点ICU科室,及呼吸机应用ICU人群的院内感染防控,同时预防革兰阴性菌等重点菌株的院内感染。
Objective To investigate the results of target surveillance of nosocomial infection in intensive care unit(ICU) of general hospital.Methods A total of 51126 patients with targeted monitoring in ICU were selected from a general hospital from November 1,2019 to October 31,2022.The infection-related data were retrospectively collected,and were summarized and analyzed from different ICU patients,different infection sites,different catheter-associated infection,and different distribution of infectious pathogens.Results A total of 1133 cases and 1183 times of nosocomial infection were detected.The infection rate and infection times were 2.22%(1133/51126) and 2.31%(1183/51126),respectively.The nosocomial infection rate and case rate of ICU patients in different departments were significantly different(χ^(2)=291.697,P<0.001;χ^(2)=302.172,P<0.001).The nosocomial infection rate and case rate of neurological ICU were the highest [3.82%(174/4553) and 4.06%(185/4553)].In the analysis of targeted monitoring of device-associated infection in ICU,there were significant differences in the incidence rate and daily incidence rate of infection in patients with ventilator,central venous intubation and catheter catheterization(χ^(2)=98.068,P<0.001;χ^(2)=22.726,P<0.001).The highest values were 2.25%(131/8226) and 0.351‰(131/374285) in ICU patients using ventilator,respectively.A total of 1650 strains of pathogenic bacteria were detected from the infected site,among which gram-negative bacteria(62.97%) and gram-positive bacteria(28.00%) were dominant,and fungi accounted for the lowest proportion(9.03%).Conclusions The target monitoring of nosocomial infection in ICU in general hospitals can provide reference for nosocomial infection prevention and control.It is necessary to strengthen the prevention and control of key ICU departments such as neurological ICU,comprehensive ICU,and ICU patients with ventilator application,and prevent nosocomial infection of key strains such as gram-negative bacteria.
作者
王秋亚
明帅
Wang Qiuya;Ming Shuai(Department of Infection Management,the First Afiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ophthalmology,Henan Provincial People's Hospital,Zhengzhou 450003,China)
出处
《临床医学》
CAS
2023年第6期16-19,共4页
Clinical Medicine
作者简介
通信作者:明帅,Email:WQYWQYWQY@163.com。
