重症监护病房医院感染的防治要点

目的了解综合性医院ICU患者的医院感染率及特点。方法监测2012年3—8月收治的ICU患者医院感染率，以患者平均病情严重程度评分（ASIS）调整感染率。观察3种侵袭性操作导致的感染和病原菌的分布情况。结果3700例患者中发生医院感染357例，感染率为9．65％；日感染率为30．34％。；呼吸机相关性肺炎日感染率为49．10‰、导管相关血流感染日感染率为13．86％o、导管相关尿路感染日感染率为1．09％o。共检出688株病原菌，以革兰阴性杆菌为主（82．70％），前3位病原菌为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌。结论ICU是医院感染的重点科室，应重视对该科室医院感染的监测。

Implications for control of nosocomial infections in intensive care unit

Objective To summarize the characteristics of nosocomial infections in the patients treated in intensive care unit （ICU）. Methods The incidence of nosocomial infections was monitored in ICU from March 2012 to August 2012. The incidence rate of infection was adiusted with Average Severity of Illness Score （ASIS） score and analyzed in relation to three invasive pro- cedures. Pathogen distribution of nosocomial infections in ICU was also analyzed. Results Nosocomial infection was identified in 357 of the 3 700 ICU patients （9.65%）. The overall daily infection rate was 30.34%o, specifically, 49.10‰ for ventilator asso- ciated pneumonia （VAP）, 13. 86‰ for catheter-related bloodstream infections （CRBSI）, and 1. 09%o for catheter-associated urinary tract infections （CAUTI）. Of the 688 bacterial isolates, gram negative bacteria accounted for 82.70%. The top three bacterial species were Acinetobacter baumanii, Pseudornonas aeruginosa, and Klebsiella pneumoniae. Conclusions ICU is the focus for surveillance of nosocomial infections. Objective investigation is critical for nosocomial infection surveillance.