导尿管相关尿路感染的监测及分析
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彭泽萍

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R181.3+2

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医院感染预防与控制能力建设项目(CHA-2012-XSPX-0629-1)


Monitoring and analysis on urinary catheterassociated urinary tract infection
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    摘要:

    目的了解留置导尿管患者导尿管相关尿路感染(CAUTI)发生情况,为降低CAUTI发病率提供依据。方法根据中国医院协会医院感染管理专业委员会“医院感染预防与控制能力建设项目”CAUTI监测项目要求,采用前瞻性监测方法,对某院2014年1—12月住院并接受留置导尿管≥2 d患者进行CAUTI监测,并比较不同患者情况CAUTI发病率。结果共监测留置导尿管患者6 046例,发生CAUTI 166例,留置导尿管总日数31 833 d,CAUTI发病率为2.75%、5.21‰。不同性别患者CAUTI发病率比较差异无统计学意义(χ2=1.23,P=0.54);>60岁组(4.72%)CAUTI发病率高于≤60岁组(2.07%),差异有统计学意义(χ2=30.38,P<0.01);不同留置导尿管时间患者CAUTI发病率比较差异有统计学意义(χ2= 251.14,P<0.01);随着导尿管留置时间的延长,CAUTI发病率也随之增高(趋势χ2=211.82,P<0.001)。神经内科平均留置导尿管时间最长(14.84 d),CAUTI发病率最高(15.00%、10.11‰);其他外科留置时间最短(3.56 d),CAUTI发病率最低(0.97%、2.74‰);不同科室留置导尿管患者CAUTI发病率(%)比较差异有统计学意义(χ2= 302.24,P<0.001)。166例CAUTI患者检出病原菌66株,以革兰阴性杆菌为主(占86.36%),大肠埃希菌占33.33%。结论CAUTI与患者年龄、留置导尿管时间有关,每日评估导尿管留置的必要性并及时拔管有利于减少CAUTI的发生。

    Abstract:

    ObjectiveTo understand the occurrence of catheterassociated urinary tract infection(CAUTI) in patients with  catheterization, and provide evidence for reducing the incidence of CAUTI. MethodsBased on monitoring requirement for  CAUTI in competency building project of healthcareassociated infection(HAI) prevention and control established by Hospital Infection Management Committee of Chinese Hospital Association, CAUTI among patients who hospitalized and received urinary catheterization ≥2 days in a hospital from January to December 2014 were analyzed prospectively, incidences of CAUTI in different patients were compared. ResultsA total of 6 046 patients with  urinary catheterization were monitored, 166 of whom developed CAUTI, incidence of CAUTI was 2.75%, the total urinary catheter days were  31 833 days, incidence of CAUTI was 5.21 per 1 000 urinary catheter days. There was no significant difference in the incidence of CAUTI among patients of different genders (χ2=1.23,P=0.54);incidence of CAUTI in patients > 60 years old was higher than those ≤60 years (4.72%  vs 2.07%, χ2=30.38,P<0.01);incidence of CAUTI in patients with different duration of catheterization was significantly different(χ2= 251.14,P<0.01);with the prolongation of  duration of catheterization, incidence of CAUTI also increased(trend  χ2=211.82,P<0.001).Patients in department of neurology had the longest average catheterization time(14.84 days)and highest incidence of CAUTI(15.00%, 10.11‰);patients in the other departments of surgery  had the shortest average catheterization time(3.56  days)and lowest incidence of CAUTI(0.97%,2.74‰);incidences of CAUTI in patients with urinary catheterization in different departments were significantly different(χ2= 302.24,P<0.001). 166 CAUTI patients were isolated 66 isolates of pathogenic strains, 86.36% were gramnegative bacilli, 33.33%  of which were Escherichia coli. ConclusionCAUTI is related to the age of patients and duration of indwelling urinary catheter. Daily assessment on the necessity of indwelling catheter and timely removal of catheter is helpful for reducing the occurrence of CAUTI.

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引用本文

徐光琴, 彭泽萍, 杜迎春,等.导尿管相关尿路感染的监测及分析[J]. 中国感染控制杂志,2016,15(7):495-497. DOI:10.3969/j. issn.1671-9638.2016.07.013.
XU Guangqin, PENG Zeping, DU Yingchun, et al. Monitoring and analysis on urinary catheterassociated urinary tract infection[J]. Chin J Infect Control, 2016,15(7):495-497. DOI:10.3969/j. issn.1671-9638.2016.07.013.

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  • 收稿日期:2015-09-29
  • 最后修改日期:2015-12-26
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  • 在线发布日期: 2016-07-30
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