重症监护病房连续11年器械相关医院感染目标性监测

 目的 了解某院重症监护病房（ICU）医院感染特点，为医院感染管理提供科学依据。方法 2010年1月—2020年12月对该院ICU开展医院感染连续目标性监测，分析ICU患者医院感染的监测结果。结果 11年共收治患者4 901例，其中发生医院感染400例，医院感染发病率为8.16%，调整后的患者日感染率为4.14‰。不同年份ICU医院感染发病率随年份变化呈下降趋势（P<0.01）。医院感染以呼吸系统为主（占46.08%），器械相关感染160例次，其中呼吸机相关肺炎（VAP）占66.25%。VAP发病率为8.64‰，中心静脉导管相关血流感染发病率为2.37‰，导尿管相关尿路感染发病率为1.51‰，不同年份器械使用率有所降低，器械相关感染发病率随年份变化均呈下降趋势（均P<0.05）。共检出病原菌2 198株，以革兰阴性菌为主（占72.61%）。结论 器械相关感染仍是ICU医院感染的重点，应持续开展ICU医院感染目标性监测工作，及时发现问题，采取有效的控制措施，降低医院感染发病率。

Targeted monitoring on device-associated healthcare-associated infection in an intensive care unit for 11 consecutive years

Objective To understand the characteristics of healthcare-associated infection (HAI) in intensive care unit (ICU) of a hospital, and provide scientific basis for management of HAI. Methods From January 2010 to December 2020, continuous targeted monitoring on HAI was carried out in ICU of the hospital, monitoring results of HAI in ICU patients were analyzed. Results A total of 4 901 patients were admitted to this hospital in 11 years, 400 cases of HAI occurred, incidence of HAI was 8.16%, and the adjusted HAI rate was 4.14‰ per 1 000 bed-day. Incidence of ICU in different years showed a decreasing trend with the change of year (P<0.01). The main HAI was respiratory system infection (46.08%), there were 160 cases of device-associated infection, ventilator-associated pneumonia (VAP) accounted for 66.25%. Incidences of VAP, central line-associated bloodstream infection, and catheter-associated urinary tract infection were 8.64‰, 2.37‰, and 1.51‰ respectively. Utilization rate of devices decreased in different years, device-associated infection rate decreased with years (all P<0.05). A total of 2 198 strains of pathogens were isolated, mainly Gram-negative bacteria (72.61%). Conclusion Device-associa-ted infection is still the focus of HAI in ICU, targeted monitoring on HAI in ICU should continue to be carried out, problems should be found in time, effective control measures should be taken to reduce the incidence of HAI.