综合重症监护病房导管相关感染目标性监测分析

摘要

Objective To monitor the incidence of catheter-associated infection (CAI)in patients in general inten-sive care unit (ICU),and provide basis for taking proper prevention and control measures.Methods Targeted monitoring method was conducted,incidence of healthcare-associated infection (HAI)among patients receiving urinary catheterization,intravascular catheterization,and tracheal intubation in the general ICU of a tertiary hospital between January 2012 and December 2013 were surveyed.Results A total of 299 ICU patients with catheterization were investigated,the overall hospitalization days were 2 700 days,41 patients developed 48 episodes of HAI, incidence of HAI was 13.71%,case incidence was 16.05%,incidence of HAI per 1 000 catheter days was 15.19‰,37 patients developed 44 episodes of CAI;the other types of HAI were blood stream infection(n=1),skin and soft tissue infection(n = 1 ),antibiotic-associated diarrhea(n = 1 ),and herpes zoster(n = 1 ).Incidence of catheter-associated urinary tract infection (CAUTI),catheter-related bloodstream infection (CRBSI),and ventilator-associated pneumonia (VAP ) per 1 000 catheter days were 2.94‰,2.12‰,and 15.72‰ respectively. Conclusion CAI is the main HAI type in ICU patients with catheterization,and the major is VAP.%目的：监测重症监护病房（ICU）患者导管相关感染发病情况，为采取相关预防与控制措施提供依据。方法采用目标性监测方法，调查某三级综合医院2012年1月—2013年12月入住综合 ICU 且使用了导尿管、血管导管，以及气管插管使用呼吸机的患者医院感染发病情况。结果共调查综合 ICU 导管置管住院患者299例，总住院日数为2700 d，发生医院感染41例、48例次，医院感染发病率为13．71％、例次发病率为16．05％，日感染发病率为15．19‰；其中发生导管相关感染者37例、44例次；其他医院感染分别为血流感染、皮肤软组织感染、抗菌药物相关性腹泻及带状疱疹各1例。导尿管相关泌尿道感染（CAUTI）发病率为2．94‰，血管导管相关血流感染（CRBSI）发病率为2．12‰，呼吸机相关肺炎（VAP）发病率为15．72‰。结论导管相关感染是 ICU 内导管置管患者医院感染的主要类型，且主要以 VAP 为主。