多中心ICU获得性下呼吸道感染监测报告
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蔡新宇

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R181.3+2

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湖北省教学科学“十二五”规划项目(2012B083)


Multicenter monitoring report on intensive care unitacquired lower respiratory tract infection
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    摘要:

    目的了解重症监护室(ICU)获得性下呼吸道感染情况及病原体分布特点,为采取预防控制措施和科学诊治患者提供依据。方法采用回顾性调查,收集某省32所医院ICU 2013年全年医院感染目标性监测资料。结果32所医院,ICU获得性下呼吸道感染发病率为5.79%,呼吸机使用率为31.25%,呼吸机相关性肺炎(VAP)发病率为26.93‰;呼吸机使用率与VAP发病率相关性分析(r=0.160,P=0.380),差异无统计学意义,两者无直线相关关系。共检出阳性菌株1 593株,其中以革兰阴性菌居多(1 207株,占75.77 %),其次为革兰阳性菌(290株,占18.21%),真菌(94株,占5.90%),肺炎支原体和其他病原体(各1株,占0.12 %)。下呼吸道感染病原体居前5位的分别是鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌,分别占25.49%、15.26%、14.63%、13.37%和5.09%。结论ICU目标性监测有助于了解医院获得性下呼吸道感染情况,各医院应针对本单位的监测结果,积极查找原因,并加强ICU医院感染控制标准规范的学习,开展目标性监测,提高ICU医务人员对VAP感染预防措施的认知程度与措施执行力。

    Abstract:

    ObjectiveTo understand the status of intensive care unitacquired lower respiratory tract infection (ICULRTI), and the distribution characteristics of pathogens, so as to provide the basis for taking preventive and control measures, and scientific diagnosis and treatment for patients.  MethodsTargeted monitoring data on healthcareassociated infection (HAI) in ICUs of 32 hospitals in a province in 2013 were investigated retrospectively. ResultsThe incidence of ICULRTI was 5.79%, ventilator usage rate  was 31.25%, incidence of ventilatorassociated pneumonia(VAP) was 26.93‰;There was no linear correlation between ventilator usage rate and incidence of VAP(r=0.160,P=0.380). A total of 1 593 pathogens causing LRTI were detected, the major were gramnegative bacteria (75.77 %,n=1 207), followed by grampositive bacteria(18.21%,n=290),fungi(5.90%,n=94),Mycoplasma pneumonia and other pathogens(0.12 %, n=1 for each).The top five detected pathogens causing LRTI were Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli, accounting for 25.49%, 15.26%, 14.63%, 13.37% and 5.09% respectively.ConclusionTargeted monitoring on ICU is helpful for realizing healthcareassociated  LRTI, each hospital should conduct targeted monitor to find out the causes of HAI, as well as improve the awareness of VAP among ICU health care workers.

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薛菊兰,蔡新宇,王向荣.多中心ICU获得性下呼吸道感染监测报告[J]. 中国感染控制杂志,2015,14(2):77-80. DOI:10.3969/j. issn.1671-9638.2015.02.002.
XUE Julan, CAI Xinyu, WANG Xiangrong. Multicenter monitoring report on intensive care unitacquired lower respiratory tract infection[J]. Chin J Infect Control, 2015,14(2):77-80. DOI:10.3969/j. issn.1671-9638.2015.02.002.

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  • 收稿日期:2014-06-22
  • 最后修改日期:2014-07-12
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  • 在线发布日期: 2015-02-28
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