首页|2018-2022年肝移植监护病房医院感染目标性监测结果分析

2018-2022年肝移植监护病房医院感染目标性监测结果分析

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目的 分析肝移植监护病房患者医院感染的发病特征,为有效防控肝移植术后感染提供依据。方法 回顾性分析2018-2022年肝移植监护病房的医院感染目标性监测资料,分析发病率、发病趋势、感染部位、病原菌及其耐药情况。结果 共监测3 762例肝移植患者,发生医院感染106例、133例次,发病率为2。82%,例次发病率为3。54%,各年间比较差异无统计学意义(P=0。473)。感染主要发生在入住监护病房2周内,占85。85%;感染部位主要包括血液系统(26。32%)、呼吸系统(22。56%)和手术部位(19。55%);中心静脉置管、导尿管插管和呼吸机的平均使用率分别为85。77%、70。58%、40。83%,中心静脉导管相关血流感染(CLRBSI)、导尿管相关尿路感染(CAUTI)、呼吸机相关肺炎(VAP)的发病率分别为0。54‰、0。33‰、1。84‰。共检出病原菌131株,其中革兰阴性菌占38。17%,革兰阳性菌占29。77%,前三位病原体分别为肺炎克雷伯菌(15。27%)、屎肠球菌(11。45%)、鲍曼不动杆菌(9。16%)。结论 应针对肝移植监护病房医院感染发病特征采取有效防控措施,遏制细菌耐药,减少肝移植术后医院感染。
Targeted surveillance results of healthcare-associated infection in the liver transplantation intensive care unit from 2018 to 2022
Objective To analyze the characteristics of healthcare-associated infection(HAI)in patients in liver transplantation intensive care unit(ICU),and provide basis for the effective prevention and control of liver post-transplantation infection.Methods Targeted surveillance data of HAI in liver transplantation ICU from 2018 to 2022 were analyzed retrospectively.Incidence,incidence trend,infection site,pathogens and drug resistance were analyzed.Results A total of 3 762 liver transplantation patients were surveilled,106 patients developed 133 cases of HAI,with an incidence of 2.82%and a case incidence of 3.54%.There was no significant difference among the years(P=0.473).Infection mainly occurred within 2 weeks after admission to ICU,accounting for 85.85%.The main infection sites included blood system(26.32%),respiratory system(22.56%),and surgical site(19.55%).The average utilization rates of central veinous catheterization,urethral catheterization,and ventilator were 85.77%,70.58%,and 40.83%,respectively.The incidences of central line-associated bloodstream infection(CLABSI),catheter-associated urinary tract infection(CAUTI),and ventilator-associated pneumonia(VAP)were 0.54‰,0.33‰,and 1.84‰,respectively.A total of 131 strains of pathogens were detected,of which Gram-negative bac-teria accounted for 38.17%and Gram-positive bacteria accounted for 29.77%.The top three pathogens were Kleb-siella pneumoniae(15.27%),Enterococcus faecium(11.45%),and Acinetobacter baumannii(9.16%).Conclusion Effective prevention and control measures should be taken based on the characteristics of HAI in the liver transplan-tation ICU,so as to curb bacterial resistance and reduce liver post-transplantation HAI.

transplantation intensive care unithealthcare-associated infectiontargeted surveillancepathogendrug resistanceliver transplantation

杨亚、丁佳燕、黄妹、陆峰、沈瑞红、秦娟秀、周文琴、傅小芳、班海群、邓羽霄、郑军华

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上海交通大学医学院附属仁济医院感染管理办公室,上海 200127

上海交通大学医学院附属仁济医院重症医学科,上海 200127

上海交通大学医学院附属仁济医院检验科,上海 200127

上海交通大学医学院附属仁济医院泌尿科,上海 200127

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移植监护病房 医院感染 目标性监测 病原体 耐药性 肝移植

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(12)