综合ICU留置导管患者医院感染剖析.docVIP

综合ICU留置导管患者医院感染剖析 　　[摘要]目的 了解综合ICU留置导管患者医院感染特点，为预防和控制医院感染提供依据。方法 收集2013年1月～2015年12月ICU监测数据，调查住院患者导管相关性感染发生情况。结果 综合3年2855例患者发生医院感染269例，感染例次发生率为9.42%，日感染率为27.83‰；发生导管相关性感染174例，占ICU医院感染的64.68%；呼吸机相关性肺炎、中心静脉导管相关血流感染、导尿管相关尿路感染日感染率分别为26.66‰、3.06‰和3.22‰；3种导管相关性感染日感染率经年度趋势性卡方检验，差异有统计学意义（P0.05）；医院感染病原菌以革兰阴性菌为主，其中鲍氏不动杆菌检出率最高。结论 综合ICU医院感染的主要类型是导管相关性感染，以呼吸机相关性肺炎发生率最高。 　　[关键词]重症监护病房；留置导管；导管相关性感染 　　[中图分类号] R195 [文献标识码] A [文章编号] 1674-4721（2016）10（b）-0147-03 　　[Abstract]Objective To explore the characteristics of nosocomial infection in patients with indwelling catheter in ICU and to provide evidence for the prevention and control measures through the analysis of the surveillance data of catheter-associated infections in the ICU patients.Methods The incidence of catheter related infections in hospitalized patients were monitored by collecting from January 2013 to December 2015.Results The nosocomial infections occurred in 269 of 2855 patients with the infection rate of 9.42% and daily infection rate was 27.83‰；there were 174（64.88%） patients with catheter-associated infections；the incidences of ventilator-associated pneumonia，venous catheter-associated bloodstream and urinary catheter-associated urinary tract was 26.66‰，3.06‰，3.22‰；the annual trend of chi square test of 3 kinds of catheter related infection rate of infection of the day，the difference was statistically significant（P0.05）.Gram negative bacteria were the main pathogens of nosocomial infection，and the detection rate of Acinetobacter baumannii was the highest.Conclusion Catheter-associated infection is the main type of nosocomial infection in ICU，and the incidence of ventilator associated pneumonia is the highest. 　　[Key words]Intensive care unit；Indwelling catheter；Catheter-associated infection 　　重症监护病房（ICU）患者大多具有免疫力低下、伴有严重基础疾病、病情较重等特点，多数患者需实施气管插管、留置深静脉导管或导尿管等侵入性操作，这些诊疗操作破坏了人体正常的防御屏障，是导致医院感染发生的重要因素，而导管相关性感染发病率是评价ICU医院感染防控水平的重要指标[1]。为了解ICU医院感染特点，有效预防和控制医院感染，本研究对重庆医科大学附属永川医院ICU留置导管患者感染资料进行汇总、分析。 　　1资料与方法 　　1.1一般