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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 understand the current situation and trend of nosocomial infection in a “top 3 ” hospital ICU in Beijing. Methods: Surveillance data were collected from all patients admitted to the SICU from January 2008 to December 2010 in the hospital from January 2008 to December 2010. Results: Of the 2279 patients, 283 were hospital-acquired infections, with an infection rate of 12.4%. The most common respiratory tract was the respiratory tract with a prevalence of 59.0% (222/376), of which ventilator-associated pneumonia (VAP) The infection rate was 63.9% (142/222). The most common pathogenic bacteria in hospital were Gram-negative bacteria. The main pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Candida albicans and so on. Conclusions: The incidence of nosocomial infections in SICU is high, and invasive operation-related infections account for the majority, with VAP as the baseline. To prevent and control SICU’s nosocomial infections, targeted monitoring of invasive operations should be strengthened and close cooperation should be established with hospital administrators, medical staff, medical assistants, patients and their families to enhance the implementation of rules and regulations.