2004～2006ICU医院感染状况调查与分析

发布时间：2018-06-23 02:30

本文选题：医院感染 + 加强治疗病房　；参考：《新疆医科大学》2007年硕士论文

【摘要】： 目的:1)了解加强治疗病房(Intansive Care Uite,ICU)医院感染(nosocomialinfection,NI)的患病率和感染部位的状况;2)了解ICU医院感染的病原体分布,为临床诊疗提供依据;3)为ICU合理使用抗生素,降低细菌耐药性的产生,同时提高感染的治疗水平;4)为ICU医院感染的预防和医护人员个人防护提供依据。方法:对ICU 2004年1月至2006年12月间2739份出我科病例进行回顾性调查,有193例病例符合医院感染诊断标准,同时按剔出标准排出部分病例。再对这193例医院感染病例通过查阅病史、医院感染登记表等,填写统一调查表。调查内容主要包括性别、年龄、原发病情况、住院天数、感染日期、易感因素、侵入性操作和抗生素使用情况、医院感染部位、致病菌及药敏等进行回顾性分析。其中计量资料以均数±标准差表示,计数资料用多个样本率的比较及率的两两比较用Scheffe法,以上所有数据应用SPSS13.0软件处理;检验水准α=0.05。结果:2004年～2006年ICU医院感染的平均感染率17.64%;常见感染部位是呼吸道(73.91%)、血液(6.74%)、胸膜腔(6.30%)、腹腔(6.09%)、切口(3.26%)和泌尿道(2.61%)。各部位主要病原菌种类具有统计学差异,呼吸道、胸腹腔以细菌为主,泌尿道以真菌为主,混合感染49.22%。医院获得性感染的常见病原菌是铜绿假单胞菌、肺炎克雷伯菌、大肠埃希氏、金黄色葡萄球菌、醋酸钙鲍曼复合不动杆菌和阴沟肠杆菌。抗生素存在过度使用问题,使用较频繁的抗生素为头孢类、左氧类和泰能等。结论:ICU内医院感染的患病率人居高不下,应加强医院感染防治,从而降低ICU医院感染的总体水平。ICU医院感染部位中仍以呼吸道为主,应加强空气的传播的防护,医务人员同时应加强呼吸道的防护以减少自身医院感染。ICU医院感染主要病原菌因感染部位不同而不同,菌种复杂,耐药菌株多,应针对感染部位的区别和菌种的区别具体做好ICU医院感染的防护,有针对性对ICU医院感染的具体环节予以控制。掌握病原菌变化规律,为ICU合理使用抗生素作指导,降低细菌耐药性的产生,同时提高感染的治疗水平。从而从各方面有效地预防和治疗ICU内获得性感染。
[Abstract]:Objective: to understand the prevalence of nosocomial infection (NI) in intensive Care Unit (ICU) and the location of nosocomial infection. (2) to understand the distribution of pathogens of nosocomial infection in ICU so as to provide a basis for clinical diagnosis and treatment. At the same time, to improve the treatment level of infection. 4) to provide evidence for the prevention of nosocomial infection in ICU and the personal protection of medical staff. Methods: from January 2004 to December 2006, 2739 cases of our department were retrospectively investigated. 193 cases met the diagnostic criteria of nosocomial infection, and some cases were excluded according to the criteria of excision. The 193 cases of nosocomial infection were filled out the unified questionnaire by consulting the history, the registration form of nosocomial infection and so on. Sex, age, primary disease, hospitalization days, date of infection, susceptible factors, invasive operation and use of antibiotics, nosocomial infection site, pathogenic bacteria and drug sensitivity were analyzed retrospectively. The measurement data are expressed as mean 卤standard deviation, and the counting data are compared by multiple sample rates and by Scheffe method. All the above data are processed by SPSS 13.0 software, and the test level is 伪 0.05. Results: the average nosocomial infection rate in ICU from 2004 to 2006 was 17.64.The common infection sites were respiratory tract (73.91%), blood (6.74%), pleural cavity (6.30%), abdominal cavity (6.09%), incision (3.26%) and urinary tract (2.61%). The main pathogens were mainly bacteria in respiratory tract, chest and abdomen, fungi in urinary tract, and mixed infection in 49.2222. The common pathogens of nosocomial infection are Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Acinetobacter and Enterobacter cloacae. The overuse of antibiotics is a problem, and the frequently used antibiotics are cephalosporins, levamoxins and Tyranone, etc. Conclusion the prevalence rate of nosocomial infection in ICU remains high and the prevention and treatment of nosocomial infection should be strengthened so as to reduce the overall level of nosocomial infection in ICU. The respiratory tract is still dominant in the nosocomial infection in ICU and the prevention of air transmission should be strengthened. At the same time, medical staff should strengthen respiratory tract protection to reduce their own nosocomial infection. The main pathogens of nosocomial infection in ICU are different because of different infection sites, complex strains and many drug-resistant strains. The prevention of nosocomial infection in ICU should be done according to the difference of infection sites and strains, and the specific links of nosocomial infection in ICU should be controlled. To master the regularity of pathogenic bacteria, to guide the rational use of antibiotics in ICU, to reduce the production of bacterial drug resistance, and to improve the treatment level of infection. In order to effectively prevent and treat acquired infection in ICU from various aspects.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R181.3

【参考文献】