不同类型ICU导尿管相关尿路感染发病率多中心研究

目的旨在通过开展导尿管相关尿路感染(CAUTI)的防控建设项目,提高医护人员的感染防控意识,促进感染防控措施的落实。方法统一采用美国疾病控制与预防中心/国家医疗保健安全网络(CDC/NHSN)2009年发布的CAUTI诊断标准,对2013年10月—2014年9月监测医院不同类型重症监护病房(ICU)中留置导尿管持续时间2 d的住院患者进行CAUTI监测。结果共收集合格病例14 124例,410例发生CAUTI,导尿管使用率是79.33%(203 114/256 042),CAUTI发病率为2.02‰(410/203 114),尿培养送检率为46.52%(6 570/14 124)。按季度统计尿培养送检率由第1监测季度(2013年第4季度)的37.24%,提升至第4监测季度(2014年第3季度)的49.76%。防控措施中,具有置管指征比较,差异有统计学意义(P0.01)。结论通过"医院感染预防与控制能力建设"项目的开展,CAUTI的防控取得了良好的干预效果。

Multicenter study on incidences of catheter associated urinary tract infection in different kinds of intensive care units

ObjectiveTo improve health care workers’ （HCWs） infection prevention and control consciousness through carrying out catheter associated urinary tract infection(CAUTI) prevention and control project,and implement prevention and control measures in practical work.MethodsDiagnostic criteria of CAUTI issued by the U.S. Centers for Disease Prevention and Control / National Healthcare Safety Network were adopted, from October 2013 to September 2014, monitoring was conducted on CAUTI in patients with indwelling urinary catheters for ＞2 consecutive days at different types of ICUs in hospitals participated in the project .ResultsA total of 14 124 CAUTI cases were collected, 410 patients developed CAUTI, urinary catheter usage rate was 79.33%(203 114/256 042), incidence of CAUTI was 2.02‰(410/203 114), urine specimen detection rate was 46.52%(6 570 /14 124). The detection rate of urine specimens increased from 37.24% (the fourth quarter of 2013) to 49.76% (the third quarter of 2014). Of prevention measures, the difference in the indication of catheterization was significantly different(P<0.01).ConclusionThrough the development of competence building project of healthcare associated infection prevention and control, prevention and control of CAUTI has achieved good intervention effect.