目的 通过对2016-2022年南京市某医院开展重症医学病房(intensive care unit,ICU)医院感染目标性监测,了解医院感染情况,为预防与控制医院感染发生提供依据.方法 对2016-2022年南京市某医院综合ICU的2 288例患者进行目标性监测,分析医院感染率、器械使用情况、感染部位分布及病原菌检出情况.计数资料以百分比表示,数据比较采用x2检验或Fisher精确概率法.结果 2 288例患者中发生医院感染124例,医院感染发病率为5.42％.不同年份医院感染发病率呈逐年下降趋势(x2=16.787,P＜0.001),发病(例次)率为5.73％.中心静脉导管相关血流感染、呼吸机相关肺炎、导尿管相关尿路感染发病率分别为1.33‰、3.85‰、1.52‰.感染部位以下呼吸道居多,占53.44％.医院感染病原菌以革兰阴性菌为主,占73.68％.医院感染居前3位的病原菌分别为铜绿假单胞菌(16.67％)、肺炎克雷伯菌(14.04％)、金黄色葡萄球菌(12.28％).结论 2016-2022年南京市某医院ICU医院感染目标性监测提示,医院感染发病率呈整体下降趋势.以下呼吸道感染为主,器械相关感染中呼吸机相关肺炎发病率较高.通过采取多科室联动的综合改进措施可降低器械相关感染发病率,减少医院感染的发生.
Analysis of objective monitoring of nosocomial infection in a comprehensive ICU of a hospital from 2016 to 2022
Objective To understand the situation of nosocomial infection and provide a basis for the prevention and control of nosocomial infection occurrence by carrying out objective monitoring of nosocomial infection in intensive care unit(ICU)of a hospital in Nanjing City from 2016 to 2022.Methods Objective monitoring was conducted on 2 288 patients in a comprehensive ICU of a hospital in Nanjing City from 2016 to 2022 to analyze the nosocomial infection rate,the use of instruments,the distribution of infection sites and the detection of pathogenic bacteria.Count data were expressed as percentages,and data were compared using the Chi-square test or Fisher exact probability method.Results A total of 124 cases of nosocomial infection occurred among 2 288 patients,with an incidence rate of nosocomial infection of 5.42％,with a decreasing trend of nosocomial infection from year to year in different years(x2=16.787,P＜0.001),and an incidence(cases)rate of 5.73％.The incidence rates of central venous catheter associated-bloodstream infection,ventilator-associated pneumonia,and catheter-associated urinary tract infection were 1.33‰,3.85‰,and 1.52‰,respectively.The most common infection site was the lower respiratory tract,accounting for 53.44％.The main pathogenic bacteria of nosocomial infection were Gram-negative bacteria,accounting for 73.68％.The top three pathogenic bacteria of nosocomial infection were Pseudomonas aeruginosa(16.67％),Klebsiella pneumoniae(14.04％),and Staphylococcus aureus(12.28％).Conclusion Objective monitoring of nosocomial infection in an ICU of a hospital in Nanjing City from 2016 to 2022,indicates an overall decreasing trend in the incidence rate of nosocomia infections.The main infection is lower respiratory tract infection,and the incidence rate of ventilator-associated pneumonia is higher among device-associated infections.The incidence rate of device-related infection and nosocomial infection should be reduced by adopting the comprehensive improvement measures of multi-department linkage.
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