目的:了解北京市某“三甲”医院重症监护病房的医院感染现状及变化趋势.方法:采用目标监测法收集该院2008年1月至2010年12月所有入住外科重症监护病房(SICU)患者的监测数据.结果:2279例患者中有283例发生医院感染,感染率为12.4％;感染部位以下呼吸道为主,例次率为59.0％ (222/376),其中呼吸机相关性肺炎(VAP)占下呼吸道感染的例次率为63.9％ (142/222);医院感染病原菌以革兰阴性菌为主,主要病原菌为鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌和白色念珠菌等.结论:SICU的医院感染发生率较高,侵袭性操作相关感染占主要部分,以VAP为著.预防与控制SICU的医院感染,应加强侵袭性操作的目标监测和医院管理人员、医护人员、医疗辅助人员、患者及家属等的密切协作,提高规章制度的执行力.%Objective: To investigate the situation of the nosocomial infection in SICU in a Third-Grade Class A hospital in Beijing. Methods: Target monitoring on nosocomial infection was performed among hospitalized SICU patients from Jan 2008 to Dec 2010. Results: Totally 283 (12.4%) cases were infected among 2279 inpatients. The lower respiratory tract infection ranked the first place (222/376, 59.0%) and VAP cases accounted for 63.9% (142/222) in the lower respiratory tract infections. Gram-negatives predominated in pathogenic species and the main microorganisms included acinetobacter baumanii, pseudomonas aeruginosa, staphylococcus aureus, escherichia coli, pneumonia crayresearch bacteria and Candida albicans, etc. Conclusion: Incidence of hospital infection in SICU is higher than that in general wards. Intervention operation related infections occupies the main part, especially VAP. In order to prevent and control nosocomial infection, it is important to strengthen target monitoring, to cooperate among the hospital management personnel, clinical doctors, nurses, medical auxiliary staff, patient and family members, and to improve the execution of rules and regulations.
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