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目的探讨ICU住院患者导管相关性感染(CRI)的病原学特征以及可能的影响因素。方法对2008年1月-2009年6月医院综合ICU住院的268例患者进行观察,统计和分析这时期ICU患者的CRI发生率、病原学特征以及可能相关危险因素。结果共收集深静脉留置管、气管插管、导尿管、胸腔引流管、腹腔引流管等556根,导管检出病原菌阳性率为38.12%,CRI发生率为34.70%,每日每1000根导管发生CRI19.3次;CRI主要病原菌依次为革兰阳性球菌(50.50%)、革兰阴性杆菌(30.30%)和真菌(19.20%);非条件Logistic回归分析提示,重复置管、股静脉置管、使用多腔导管、长期留置导管和长期使用抗菌药物为CRI独立危险因素。结论 ICU住院患者CRI的主要病原菌为革兰阳性球菌;应加强控制CRI危险因素,预防医院感染的发生。
Objective To investigate the etiological characteristics of catheter-associated infections (CRI) in hospitalized patients with ICU and the possible influencing factors. Methods A total of 268 hospitalized patients with ICU in the hospital from January 2008 to June 2009 were observed. The incidence of CRI, etiological characteristics and possible risk factors of ICU in this period were statistically analyzed. Results A total of 556 deep venous catheter, endotracheal tube, catheter, chest drainage tube and abdominal drainage tube were collected. The positive rate of pathogen detection was 38.12% and the CRI incidence was 34.70% CRI occurred 19.3 times. The main pathogens of CRI were Gram-positive cocci (50.50%), Gram-negative bacilli (30.30%) and fungi (19.20%). Non-conditional Logistic regression analysis indicated that the repeated catheterization, femoral vein catheterization , The use of multi-lumen catheters, long-term indwelling catheters and long-term use of antimicrobial agents were independent risk factors for CRI. Conclusions The main pathogen of CRI in inpatients in ICU is Gram-positive cocci. The risk factors of CRI should be controlled to prevent the occurrence of nosocomial infection.