重症监护室医院感染目标性监测分析与对策

目的了解重症监护室（ICU）医院感染发病特点。方法采用目标性监测方法,对某院2006年7月—2007年6月ICU患者医院感染发病情况进行监测,并用患者平均病情严重程度（ASIS）调整法调整医院感染发病率,同时对3种侵入性操作相关感染进行分析。结果959例住ICU患者发生医院感染129例（13.45%）,222例次（23.15%）;经ASIS法调整后,日医院感染发病率为5.42‰,日医院感染例次发病率为9.33‰。3种侵入性操作相关感染日感染率分别为：呼吸机相关肺部感染37.10‰、留置导尿管相关泌尿道感染4.02‰,动静脉插管相关血流感染5.83‰。结论ICU医院感染率高,是医院感染监测的重点部门,应重视目标性监测工作;必须加强呼吸机相关物品的消毒灭菌与管理,重视对有侵入性诊疗操作患者的监护。

Study on objective surveillance and strategies of nosocomial infection in patients in intensive care unit

Objective To realize the characteristics of nosocomial infection（NI） in patients in intensive care unit （ICU）. Methods An objective surveillance method was adopted to monitor the occurrence of NI in patients in a hos pital between July 2006 and June 2007, NI rates were adjusted with ASIS method, three kinds of the invasive proce dure-associated infections were analyzed. Results One hundred and twenty nine of 959 （13.45%） inpatients devel oped 222 （23.15%） cases of NI, after adjusted with ASIS method, the daily NI rate and nosocomial case infection rate was 5.42% and 9. 33% respectively. The daily NI rates of three kinds of invasive procedure-associated NI were as follows ： 37. 10%0 in ventilator-associated pneumonia, 4. 02% in urinary catheter-associated infection, 5.83% in vascular cathetepassociated bloodstream infection. Conclusion NI is high in patients in ICU, and ICU is a key department for the surveillance of NI, attention should be paid to objective investigation; it is important to strengthen the sterilization and disinfection of ventilator-related material and the monitor of patients with invasive procedure.