摘要
目的分析ICU易发医院感染的类型和主要病原学特征,指导ICU医院感染的预防控制。方法监测2009年11月-2011年1月ICU医院感染患者,记录患者使用人工呼吸机、泌尿道插管、中心静脉插管、免疫抑制剂、放疗化疗等易感因素;且采集相应标本进行病原学检查和药敏试验。结果发生医院感染90例,其中67例送检病原学检查,送检率为74.44%,共培养出病原菌188株,其中下呼吸道、泌尿道、血液系统分别占78.19%、5.85%、14.36%;分离出的病原菌中下呼吸道革兰阴性杆菌占96.60%,泌尿道中革兰阴性杆菌和革兰阳性球菌及真菌分别占27.27%、36.36%、36.36%,而血液系统革兰阴性杆菌和革兰阳性球菌及真菌分别占48.15%、29.63%、22.22%,且它们对于多数常用抗菌药物具有耐药性。结论 ICU发生医院感染的部位主要为下呼吸道,病原菌以革兰阴性杆菌为主,它们对于抗菌药物具有多药耐药性,临床加强各种侵入性诊疗操作的管理,是避免ICU医院感染的重要措施。
OBJECTIVE To instruct medical workers to prevent and control nosocomial infections in the intensive care unit（ICU） by analyzing the types of most common nosocomial infections in ICU and the major characters of pathogens.METHODS All the nosocomial infection patients from Nov.2009 to Jan.2011 were monitored.Use of ventilator,urethral catheter,central venous catheter,immunosuppressant,radiotherapy and chemotherapy and other risk factors were recorded.Corresponding specimens were collected for etiological examination and drug susceptibility testing.RESULTS Among 90 nosocomial infection patients,67 patients had etiological examination.The examination rate was 74.44%.188 strains of pathogens were isolated.The main distribution sites of nosocomial infection were as the following： lower respiratory tract infection（97 cases）,urinary tract infection（9 cases） and blood system（21 cases）,accounting for 78.19%,5.85% and 14.36% respectively.Among the pathogens isolated from lower respiratory tract,gram-negative bacilli accounted for 96.60%.gram-negative bacilli,gram-positive cocci and fungi accounted for 27.27%,36.36% and 36.36% of pathogens from urinary tract respectively.gram-negative bacilli,gram-positive cocci and fungi accounted for 48.15%,29.63% and 22.22% of pathogens from blood system respectively,which were resistant to most common antibiotics.CONCLUSION Lower respiratory tract infection is the main nosocomial infection type in ICU.gram-negative bacilli are the main pathogenic bacteria and resistant to most common antibiotics.The management of clinic invasive treatment is the important measure to avoid nosocomial infections in the ICU.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第4期864-866,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
医院感染
病原学谱
耐药性
Intensive care unit
Nosocomial infection
Spectrum of pathogens
Drug resistance
