ICU医院感染目标性监测与危险因素分析

Targeted monitoring of ICU patients with nosocomial infection and risk factors

关键词:  ICU  医院感染  目标监测  危险因素

Key words:  intensive care unit  nosocomial infection  targeted monitoring  risk factors

摘要:

目的　通过连续3年对ICU进行医院感染目标性监测，了解ICU医院感染发生率、病原学检出情况及其相关危险因素。方法　对2015年1月至2017年12月期间入住ICU的831例患者进行医院感染目标性监测，统计感染发生率、病原菌检出情况，并分析医院感染危险因素，采用多因素logistic回归筛选出独立危险因素。结果　831例患者中共有154例患者发生医院感染，感染率为18.53%，医院感染主要致病菌以革兰阴性菌为主，多因素分析结果显示，年龄＞60岁、使用呼吸机、留置中心静脉导管、留置导尿管、抗菌药物使用＞20天是ICU患者发生感染的独立危险因素（P＜0.05）。结论　ICU医院感染发病率高，是医院感染的高危科室，应重视目标性监测工作，采取相应的预防与控制措施降低医院感染率。

Abstract:

Objective To investigate the current status of nosocomial infections, isolated pathogen species and related risk factors in ICU through targeted monitoring of ICU patients from 2015-2017 in order to take effective prevention and control measures. Methods Targeted monitoring was performed on 831 patients, who were admitted to the comprehensive ICU between Jan 2015 to Dec 2017. The risk factors of infection were analyzed, and independent risk factors were screened by multivariate logistic analysis. Results Among the 831 ICU patients, 154 patients had infection with an infection rate of 18.53%. Nosocomial infection pathogens were mainly gram-negative bacteria. Multivariate logistic regression analysis revealed that age≥60, ventilator usage, central venous intubation, urinary catheters, and time of antibacterial agents usage≥20 d were the independent risk factors for nosocomial infections in ICU. Conclusion The high incidence of nosocomial infections in ICU put patient at high risk of infection. We should pay attention to targeted monitoring and prevention and control measures should be taken in order to reduce the incidence of nosocomial infections.