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目的对医院神经重症监护病房(NICU)发生医院感染的情况开展目标性监测,探索医院感染高发原因,为制定有效的预防控制措施提供依据。方法对2011年3月1日-12月31日入住NICU 548例患者进行前瞻性监测,重点监测呼吸机相关性肺炎、导管相关性血流感染、导尿管相关性泌尿道感染,对监测数据采用SPSS17.0软件进行统计处理。结果 NICU监测期间共发生医院感染199例、266例次,感染率36.31%、例次感染率48.54%;最常见感染部位为下呼吸道感染占57.52%,其次为泌尿道、血液感染,分别占18.05%、11.28%;病原菌以革兰阴性菌为主,占82.27%,最常见为铜绿假单胞菌占26.82%;单因素分析显示,住院时间>7d、气管切开深静脉置管、留置胃管及应用抗菌药物>14d等是医院感染的危险因素,非条件多元logistic回归分析显示,住院时间>7d和气管切开可作为独立危险因素。结论 NICU医院感染率高,应加强监测、积极干预,逐步降低医院感染的发生率。
Objective To monitor the occurrence of nosocomial infections in hospital intensive care unit (NICU) and explore the causes of high incidence of nosocomial infections in order to provide basis for effective prevention and control measures. Methods From March 1 to December 31, 2011, 548 patients admitted to the NICU were prospectively monitored. Ventilator-associated pneumonia, catheter-related bloodstream infections and urinary tract-associated urinary tract infections were monitored. Monitoring data Using SPSS17.0 software for statistical processing. Results During the NICU surveillance, 199 cases were hospitalized with 266 cases, the infection rate was 36.31% and the infection rate was 48.54%. The most common infection site was lower respiratory tract infection accounting for 57.52%, followed by urinary tract and blood infection, accounting for 18.05 % And 11.28%, respectively. Gram-negative bacteria were the main pathogenic bacteria, accounting for 82.27%, the most common was Pseudomonas aeruginosa accounting for 26.82%. Univariate analysis showed that hospitalization time> 7 days, tracheotomy for deep vein catheterization, Management and application of antimicrobial drugs> 14d is a risk factor for nosocomial infection. Unconditional multivariate logistic regression analysis showed that hospitalization> 7 days and tracheotomy were independent risk factors. Conclusion NICU hospital infection rate should be strengthened to monitor and actively intervene, and gradually reduce the incidence of nosocomial infections.