摘要
目的探讨医院ICU导管相关性血流感染的风险因素及防护措施,为进一步降低血流感染发生率提供依据。方法对283例符合导管相关性血流感染诊断标准的病例进行回顾性分析。结果3年中ICU导管相关性血流感染发生率约6.29%;发生感染的283例患者中原发感染占86.4%,继发感染占13.6%;年龄>62岁占患者50.5%;抗菌药物使用率80.6%,70.9%患者使用时间≥7d,经验性用药占60.1%;置管时间≥7d占80.1%;G+球菌:凝固酶阴性葡萄球菌、金黄色葡萄球菌,肠球菌,G-杆菌:鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯茵,真菌:念珠菌为分离出最常见菌种。结论年龄、住院时间、长期使用抗菌药物史、侵入性操作和长时间置管史均是引发导管相关性血流感染易感因素。医院应制定导管相关性血流感染的预防措施和规范的操作流程,加强医护人员的教育培训,加强控制医院感染技术的研究,以降低感染率的发生。
Objective：To investigate the risk factor and protective device of nosocomial infection related with ICU catheter,so as to depress the incidence of blood infection.Methods：Analysis the 283 patients which consistent with the diagnostic criteria of blood infection from 2006 to 2008.Consults：We found that the incidenceof blood infection related with ICU catheter was 6.29%.86.4% patients among the 283 was primary infection,and the others were secondary infection,50.5% of them was older than 62;80.6% of them applied with antibacterials,and 70.9% of them were treated with antibacterials for more than 7days,60.1% of them was treated on the base of the doctors experience.80.1% of them suffered with the catheter for more than 7days.the most common pathogens were G＋ ,MRCNS,S.anreus G-, Acinetobaeter baumannii,Kiebsiella penumoniae,yeasts and catheter.Conclusion：The age, length of stay,long-term use of antibaeterials,nocuous operation and long-term use of catheter are the predisposing factors of infection.In order to depress the incidence of nosoeomial infection,the hospital has established precaution of the infection and emphasis the education and training of the staff, reinforce the research of controlling of nosoeomial infection.
