ICU医院感染相关因素目标性监测分析与预防措施

目的 了解ICU医院感染发病特点,针对性地采取控制措施.方法 采用前瞻性目标监测方法,对2009年11月-2010年10月综合ICU住院患者发生医院感染的情况进行调查,用ASIS调整法调整医院感染发病率,并对侵入性操作相关感染进行分析.结果 644例ICU住院患者中发生医院感染70例,医院感染率为10.87％,感染104例次,例次感染率16.15％,患者日感染率为8.69‰,根据病情的平均严重程度经ASIS法调整后日感染率为2.65‰;感染的发生与基础疾病、大量使用抗菌药物、各种侵入性操作、年龄大、免疫力低下等密切相关;医院感染病原菌主要是条件致病菌,以革兰阴性菌为主.结论 ICU患者是医院感染易感人群,通过目标性监测,可使监测工作有目的、有计划、有步骤地进行,在监测过程中能及时发现问题,及时解决,并能进行有针对性的干预和纠正,有利于降低医院感染率.

Targeted surveillance and preventive measures on related factors for nosocomial infections in ICU

OBJECTIVE To understand the characteristics of nosocomial infections in ICU and take targeted control measures.METHODS With the prospective target monitoring,the status of nosocomial infections in the hospitalized patients in ICU from Nov 2009 to Oct 2010 was investigated,the incidence of nosocomial infection was adjusted by using ASIS,the invasive operation-related infections were analyzed.RESULTS Among 644 hospitalized patients in ICU,nosocomial infections occurred in 70 patients with the infection rate of 10.87%,there were 104 case-times of infections with the case-time infection rate of 16.15%,the daily infection rate was 8.69 ‰,the daily infection rate was 2.65 ‰ after being adjusted with ASIS according to the average severity of the condition of the patients;the outbreak of the infection was closely related to the underlying diseases,extensive use of antimicrobial drugs,invasive operation,the advanced age and low immunity;the pathogens causing nosocomial infections were mainly the opportunistic pathogens among which gram-negative bacteria dominated.CONCLUSION ICU patients are the major population that are prone to nosocomial infections,the surveillance can be performed with the purpose,planed and orderly process;to find the problems and solve in a timely manner as well as to perform targeted inventions and correction can contribute to the reduction of nosocomial infections.