使用床旁听诊器对重症监护病房医院感染发病率的影响

目的：探讨使用听诊器对重症监护病房医院感染发病率的影响。方法：选择2014年6月1日起入住我院综合性重症监护病房（ICU）并于2015年3月30日前转出ICU或死亡的患者，总计611例，根据床位分为干预组(n=296,使用床旁听诊器进行听诊)和对照组（n=315，使用医生自带的听诊器进行听诊）。所有听诊器均在每日查房前用75%乙醇擦拭表面1次。观察记录研究期间所有对象的医院感染情况及部位、感染病原菌、生命体征和转归，转出ICU后随诊48 h，汇总数据进行统计分析。结果：干预组医院感染的发病率较对照组显著降低（9.5%vs 14.9%， P<0.05），主要表现在医院获得性下呼吸道感染的发病率较对照组明显降低（4.4%vs 8.6%），并且明显缩短ICU住院时间（12.2±9.3dvs 14.2±8.8 d），但在其他部位的院内感染、28 d病死率方面无统计学差异。结论：使用床旁听诊器能显著降低综合性ICU医院感染的发病率。

Impact of the use of stethoscopes on the incidence of nosocomial infection in intensive care unit

Objective: To investigate the impact of the use of stethoscopes on the incidence of nosocomial infection (NI) in intensive care unit (ICU).Methods: A total 611 inpatients were divided into an intervention group (n=296, using a stethoscope special for each patient) and a control group (n=315, using a doctor’s private stethoscope) according to the number of bed. The surface of these stethoscopes was wiped with a cotton impregnated with 75% alcohol solution everyday before ward-round. The incidence of NI, the sites of infection, common pathogens and outcomes were observed and the data were statistically analyzed.Results: The incidence of NI was significantly lower in the intervention group than in the control group (9.5%vs 14.9%,P<0.05), especially in the incidence of acquired lower respiratory tract infection (4.4%vs 8.6%). The time for ICU stay was also signiifcantly shorter in the intervention group than in the control group (12.2±9.3vs 14.2±8.8 days,P<0.05). However, there were no statistical differences in the incidence of NI in other sites and the 28-day mortality.Conclusion: The incidence of NI in a general ICU can be obviously reduced by the use of a special stethoscopes for each patient.