重症监护病房60例医院感染临床剖析.docVIP

重症监护病房60例医院感染临床剖析 　　Abstract:Objective: To investigate the prevention and treatment measures, based on the analysis on the intensive care unit patients with hospital infection pathogens. Methods: A retrospective analysis of 60 cases of critically ill patients in hospital intensive care unit from December 2006 to December 2011.Results: Among the 60 cases of ICU patients, minimum length of the hospitalization time is 3 d, maximum length up to 68d, the average (8.1±5.6)d. Its infection rate was increased obviously with length of stay elongation. From view of the site of infection, respiratory infections are highest among which, respiratory tract infections of Non-Department of Neurology accounted for 29.4% (5/17), respiratory tract infections of Department of Neurology accounted for 27.9% (12/43). There is no significant difference between the two groups. There are 35 isolated pathogens separated from 60 cases of patients including 17 Gram-negative bacteria, 12 gram-positive bacteria and 6 fungi.Conclusion:Use antibiotics rationally to avoid preventive medication and non-standard combination；air and environment in wards especially in emergency rooms should be disinfected and purified strictly; respiratory therapy equipment should be replaced and sterilized to avoid contamination. 　　Key words:ICU; nosocomial infection; pathogens; drug resistance 　　【中图分类号】R197.3 【文献标识码】A 【文章编号】1672-3783(2012)06-0555-02 　　重症监护病房重症患者医院感染治疗较复杂，死亡率较高。因此，必须加强重症监护病房重症患者医院感染危险因素的认识，严格掌握使用抗菌药物的原则，注意无菌操作，积极治疗原发病，增强医护人员无菌观念和合理使用抗菌药物，以有效降低医院感染的发生。本文就2006 年12月～2011 年12 月我院重症监护病房60例重症患者作一回顾性分析，现报道如下。 　　1 资料与方法 　　1.1 一般资料:本文把2006 年12月～2011年12 月我院重症监护病房60例重症患者作为研究对象， 在这60例医院感染患者中，男性36 例（60.0％），女性24 例（40.0％），平均年龄（51.8±10.4） 岁，平均住院时间（8.1±5.6）d。采集患者的血、尿、便、痰、脑脊液及分泌物，规范留取标本送检培养。其中，神经内科患者43 例，非神经内科患者17 例，基础疾病：急性脑梗死18例（30.0％）,急性脑出血12 例（20.0％），颅内感染5 例（8.3％），格林巴利综合征2 例（3.3％），SAH 6 例（100％），其他17 例（28.3％）。 　　1.2 仪器及试剂:全自动血液培养仪BACTEC9120，全自动细菌鉴定系统VITEK AMS60 和VITEK2 及仪器配套产品，CO2培养箱。BACTEC9120 系统专用含培养液全封闭采样瓶（美国BD公