综合医院呼吸机相关性肺炎发生情况及相关因素分析

目的 探讨重症监护病房(ICU)呼吸机相关性肺炎(VAP)发生情况和相关因素,为综合医院制定切实可行的VAP感染防控策略提供依据.方法 2017-2018年在某综合医院ICU(包括ICU、EICU和NICU)开展VAP目标性监测,对使用呼吸机和发生VAP的患者进行调查,分析VAP发生情况、相关因素和病原菌特点.使用SP...

Analysis on the incidence and related factors of ventilator-related pneumonia in a general hospital

  Objective  To investigate the incidence and related factors of ventilator associated pneumonia (VAP) in the intensive care unit (ICU) of a general hospital, and guide the prevention and control of VAP.  Methods  Target monitoring of VAP was carried out in the ICU of a general hospital (including ICU, EICU and NICU) from 2017 to 2018. Patients on ventilator and patients with VAP were investigated. The occurrence of VAP, related factors and pathogen characteristics were analysed. SPSS 20.0 software was used to establish a multivariate logistic regression model and analyse the related factors of VAP.  Results  (1) The utilisation rate of ventilators in ICU patients was 33.58%, a total of 58 cases of VAP infection occurred, and the infection rate of VAP was 5.89‰. The use rate of ventilators in ICU patients in 2018 was lower than that in 2017, and the difference was statistically significant (P < 0.05). (2) Age (P < 0.001), cerebral haemorrhage (P=0.028), tracheotomy (P=0.009), length of stay in the hospital (P < 0.001) and length of ventilator use (P < 0.001) were risk factors for VAP, whilst age, tracheotomy and length of ventilator use were independent risk factors for VAP (OR>1, P < 0.05). (3) The top VAP-related pathogens were Acinetobacter baumannii (27, 58.62%), Klebsiella pneumoniae (17, 24.14%), Proteus mirabilis (4, 6.90%) and Pseudomonas aeruginosa (4, 6.90%).  Conclusion  The monitoring and prevention of VAP should be strengthened, and the risk factors should be focused to reduce the incidence of VAP.