大型综合性医院ICU医院感染监测

目的 通过对ICU医院感染连续性监测分析,探索科学有效控制ICU医院感染的对策.方法 利用医院感染实时监测系统,对2010年10月-2011年4月医院ICU的医院感染情况进行监测.结果 3个ICU监测期间共有住院患者1104例,医院感染317例,感染率为28.7％,神经内科ICU、呼吸ICU、外科ICU的医院感染率分别为31.3％、28.3％、27.9％;1783株病原菌主要来自痰标本,占60.5％,其次为尿液及静脉血液,分别占13.4％、7.6％;革兰阳性菌以酿脓链球菌和凝固酶阴性葡萄球菌居多,分别占8.6％、6.4％,真菌以白色假丝酵母菌居多,占8.0％,革兰阴性菌以鲍氏不动杆菌居多,其次为铜绿假单胞菌,分别占13.9％、7.0％;抗菌药物在ICU使用率最高达到92.4％.结论 ICU医院感染实时监测是一种科学的监测方法,便于动态的了解ICU医院感染情况,针对监测的问题提出科学的感染控制方案,可最大限度地减少医院感染的发生.

Surveillance of nosocomial infections in ICU of large general hospital

OBJECTIVE To explore scientific and effective measures for nosocomial infection control and reduce nosocomial infection incidence by continuous monitoring of ICU.METHODS Real-time monitoring system was used for investigating nosocomial infections from Oct 2010 to Apr 2011 in ICU.RESULTS A total of 1104 patients in 3 ICUs were monitored,among which nosocomial infections occurred in 317 cases with the infection rate of 28.7%;the incidence of nosocomial infections in neurology department,ICU of respiratory department,and ICU of surgery department were 31.3%,28.3%,and 27.9%,respectively;1783 strains of pathogens were isolated,and most of them were from sputum which accouned for 60.5%,followed by urine and venous blood,accounting for 13.4% and 7.6%,respectively;Streptococcus pyogenes and coagulase-negative Staphylococci were the predominant gram-positive bacteria,accounting for 8.6% and 6.4%,respectively;Candida albicans ranked the NO1 among fungi,accounting for 8.0%;Acinetobacter baumannii was the predominant gram-negative bacteria,followed by Pseudomonas aeruginosa,accounting for 13.9% and 7.0%,respectively;the utilization rate of antibiotics in ICU was the highest,reaching to 92.4%.CONCLUSION Real-time monitoring of nosocomial infections in ICU is a scientific monitoring method,which facilitates the understanding of the dynamics of nosocomial infections in ICU;it is necessary to propose control program aiming at the problems in the surveillance so as to minimize the incidence of hospital infections.