ICU患者导管相关医院感染病原菌特点及目标性监测

Pathogen characteristics and objective monitoring of catheter-related hospital infections in patients in intensive care unit(ICU)

  • 摘要: 目的 探讨重症监护病房(ICU)患者目标性监测在导管相关性医院感染中的临床意义及其相关因素。方法 选取医院ICU 2015年1月-2016年12月经导管治疗的患者600例为研究对象,自2016年1月开始实施目标性监测,2015年收治的300例患者设为对照组,2016年收治的300例患者设为试验组,比较两组患者各导管相关性医院感染发生率,并分析导管相关性医院感染的病原菌情况。结果 试验组患者发生导管相关性医院感染26例,感染率为8.67%低于2015年为42例,14.00%(P<0.05);两组患者均以肺部和泌尿系统感染为主;试验组各部位感染例次为56例次少于对照组的97例次(P<0.05);两组患者呼吸机相关性肺炎(VAP)、导尿管相关尿路感染(CAUTI)、中央血管导管相关血流感染(CLABSI)发生率,差异无统计学意义。70例导管相关性医院感染患者中共检出病原菌256株,其中革兰阴性菌146株占57.03%,以鲍氏不动杆菌和肺炎克雷伯菌为主;革兰阳性菌86株占33.59%,以表皮葡萄球菌、金黄色葡萄球菌为主;真菌24株占9.38%。结论 目标性监测能规范导管的插管操作及日常使用,从而有效降低导管相关性医院感染的发生率。

     

    Abstract: OBJECTIVE To discuss the clinical significance and related factors of objective monitoring in catheter-related hospital infections in ICU. METHODS A total of 600 patients with catheter therapy in ICU from Jan. 2015 to Dec. 2016 were included in the study, the objective monitoring of catheter-related hospital infections was performed from January 2016. The 300 patients treated in 2015 were set as control group, and 300 patients treated in 2016 were set as experimental group. The catheter-related hospital infection rate was compared between the two groups, and the pathogens of the catheter-related hospital infection were analyzed. RESULTS The patients in experimental group had 26 cases of catheter-related hospital infections with the infection rate of 8.67%, which were significantly lower than 42 cases and 14.0.% in 2015(P<0.05). The two groups were infected mainly by pulmonary and urinary tract infection. The infections of experimental group were 56 cases, which were less than 97 cases of control group (P<0.05). There were no significantly differences in the incidence of VAP, CAUTI, and CLABSI between the two groups. Totally 256 strains of pathogenic bacteria were detected in 70 cases of catheter-related hospital infections, including 146 strains of gram-negative bacteria accounting for 57.03%, mainly Acinetobacter baumannii and Klebsiella pneumonia, 86 strains of gram-positive bacteria accounting for 33.59%, mainly Staphylococcus epidermidis and Staphylococcus aureus, and 24 strains of fungi. CONCLUSION Objective monitoring can regulate the intubation operation and daily use of various catheters, thus effectively reduce the incidence of catheter-related hospital infections.

     

/

返回文章
返回