【摘要】 目的:评价重症监护病房(intensive care unit,ICU)实施医院感染目标性监测与干预措施的效果。方法:通过目标性监测,同时推行综合性感染控制干预措施,掌握2011-2012年综合性ICU的住院患者医院感染发生情况、危险因素及医院感染变化趋势。结果:2011年和2012年ICU的感染率分别为21.8%、16.7%,例次感染率分别为22.7%、18.0%,经病人病情平均严重程度调整,调整后的日感染率分别为5.7‰、4.4‰(χ2=0.321,P=0.865),调整的日感染例次率5.9‰、4.7‰(χ2=0.560,P=0.454)。2011年和2012年呼吸机相关性肺炎的感染率分别为29.0‰、20.1‰,中心静脉导管相关血流感染分别为1.8‰、1.2‰,导尿管相关泌尿道感染率分别为1.3‰、0.7‰。采取干预措施后,2012年多重耐药菌的检出率总体呈下降趋势,耐甲氧西林金黄色葡萄球菌的检出率明显下降,且有统计学差异(χ2=9.05,P=0.029)。结论:实施目标性监测,采取有效干预措施,利于降低ICU医院感染的发生。更多还原

【Abstract】 Objective:To evaluate the effect of implementing targeted nosocomial infection monitoring and intervention in intensive care unit(ICU).Methods:Nosocomial infection condition of hospitalized patients,risk factors and nosocomial infection changing trend in comprehensive ICU from 2011 to 2012 were mastered by targeted nosocomial infection monitoring and intervention.Results:Infection rates of ICU in 2011 and 2012 were 20.9% and 16.7 % and case infection rates were 22.7% and 18.0%.After average severity of illness score adjustion,adjusted daily infection rates were 5.7 ‰ and 4.4 ‰(χ 2 =0.321,P=0.865)and adjusted daily infected cases rates were 5.9 ‰ and 4.7 ‰(χ 2 =0.560,P=0.454).Infection rates of ventilator-associated pneumonia in 2011 and 2012 were 29.0 ‰ and 20.1 ‰.Infection rates of central venous catheter-related bloodstream were 1.8 ‰ and 1.2 ‰.Infection rates of catheter related urinary tract were 1.3 ‰ and 0.7 ‰.In 2012,the overall detection rate of multi-drug resistant bacteria was in downward trend and detection rate of methicillin-resistant staphylococcus aureus was decreased after taking interventions,with statistically significant differences(χ 2 =9.05,P=0.029).Conclusions:Implementation of targeted monitoring and infection control measures can effectively reduce the incidence of nosocomial infection ICU.更多还原