重症监护病房导管相关性尿路感染的现状分析及干预措施

Status quo of ICU catheter-related urinary tract infection (uti) analysis and intervention measures

  • 摘要: 目的 分析重症监护病房(ICU)患者导管相关性尿路感染的现状,以制定相应的预防干预措施。方法 选取2012年1月-2015年12月留置导管患者1 596例,清晨采集清洁中段尿液进行菌株分离及药敏分析,并分析患者发生尿路感染的危险因素及干预措施。结果 确诊为导管相关性尿路感染的患者72例,感染率为4.5%;共检出126株病原菌,以真菌为主,共62株占49.2%;多因素logistic分析显示,年龄>60岁、女性、合并糖尿病、合并前列腺增生、合并肾结石及导管留置时间>7 d是ICU患者发生导管相关性尿路感染的独立危险因素(P<0.05)。结论 ICU导管相关性尿路感染中真菌感染率较高,临床上应根据ICU发生尿路感染的危险因素采取相应的干预措施,且根据药敏试验指导临床用药。

     

    Abstract: OBJECTIVE To analyzed the status quo of catheter-related urinary tract infection in the intensive care unit patients, so as to formulate the corresponding prevention interventions. METHODS A total of 1596 patients with indwelling catheter from Jan.2012 to Dec.2015 were selected. The clean middle urine of the patients early in the morning were collected for drug sensitivity analysis, and the risk factors and intervention measures of urinary tract infection in patients were analyzed. RESULTS There were 72 cases of patients occurred catheter-related urinary tract infection, with the infection rate of 4.5%. Totally 126 strains of pathogenic bacteria were detected, and mainly were 62 strains of fungi, accounting for 49.2%. The multiple factors logistic analysis showed that, age >60 years old, female, diabetes mellitus, prostatic hyperplasia, kidney stones, urethral opening cleaning <7 times per week and catheter indwelling time > 7 d were independent risk factors for catheter-related urinary tract infection in ICU patients. CONCLUSION The fungal infection rate in ICU patients with catheter-related urinary tract infection is high. It should take appropriate intervention measures in clinical according to risk factors of ICU urinary tract infection, and guide clinical medication according to susceptibility testing.

     

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