医院感染实时监控干预系统在EICU的应用研究

目的 通过医院实施实时感染监测,分析医院急诊科重症监护病房(EICU)住院患者的感染发病率、危险因素、病原菌分布等因素,及时采取有效干预手段,全面提升医院感染的预防控制与管理水平.方法 应用感染实时监控系统对EICU住院患者自入院后即实施动态感染指标的全程监控和医院感染病例自动化识别与预警.结果 2011年1-12月在EICU住院的1010例患者中,感染94例,感染率为9.3％,千日医院感染率为9.2‰,医院感染167例次,例次感染率为16.5％；感染部位前3位依次为下呼吸道100例占52.91％、泌尿道25例占13.23％,血液感染25例占13.23％;细菌培养标本送检率为40.5％,检出病原菌792株,其中革兰阴性杆菌330株占41.67％,革兰阳性球菌233株占29.42％,真菌229株占28.91％.结论 应用实时感染监控系统实现了对科室感染的全过程监测和预警,对及时发现危险因素,尽早采取干预手段,有效控制和降低医院感染发生率具有重要意义.

Study on application of real-time infection surveillance system in EICU

OBJECTIVE To apply on-line real-time infection surveillance system(RT-NISS) to analyze the incidence of nosocomial infections,risk factors,and the distribution of pathogenic bacteria in the hospitalized patients in emergency intensive care unit(EICU) so as to take timely and effective interventions and comprehensively enhance the prevention and control of nosocomial infections.METHODS RT-NISS was adopted for the entire process monitoring of dynamic infections indexes of the patients after their enrollment of the hospital as well as for the automatic identification and early warning indicators of the infections.RESULTS Of 1010 hospitalized patients in EICU from Jan to Dec 2011,94 patients were suffered from nosocomial infections with the infection rate of 9.3%,and the rate for a thousand days of hospital infection was 9.2‰,and there were 167 case-times of patients with nosocomial infections with the case-time infection rate of 16.5%;the top three infection sites were respectively as follows:100 cases with lower respiratory tract infections(52.91%),25 cases with urinary tract infections(13.23%) and 25 cases with blood infections(13.23%);the submission rate of bacterial culture specimens was 40.5%,there were 792 strains of pathogens isolated among which 330(41.67%) strains were gram-negative bacilli,233(29.42%) strains were gram-positive cocci,and 229(28.91%) strains were fungi.CONCLUSION The application of RT-NISS has made it achieve the whole process monitoring and early warning of the infections,which is of great significance in detecting the risk factors in a timely manner,taking the interventions as soon as possible,and effectively controlling and reducing the incidence of nosocomial infections.