CAJ | 학술논문

医院感染%现患率调查%重症监护室%现患率%泌尿道插管相关泌尿道感染%血管导管相关血流感染%呼吸机相关肺炎%病原体%抗菌药物醫院感染%現患率調查%重癥鑑護室%現患率%泌尿道插管相關泌尿道感染%血管導管相關血流感染%呼吸機相關肺炎%病原體%抗菌藥物
의원감염%현환솔조사%중증감호실%현환솔%비뇨도삽관상관비뇨도감염%혈관도관상관혈류감염%호흡궤상관폐염%병원체%항균약물
healthcare-associated infection%prevalence survey%intensive care unit%prevalence rate%urinary cath-eter-related urinary tract infection%intravascular catheter-related blood stream infection%ventilator-associated pneumonia%pathogen%antimicrobial agent

目的：了解我国医院综合重症监护室（ICU）医院感染发生率、常见侵入性操作使用率及相关感染率、抗菌药物使用及病原体分布情况。方法对2012年3月15日-12月31日期间上报至全国医院感染监测网医院感染横断面调查资料中综合 ICU 监测数据进行汇总分析。结果1313所医院中，621所（47．30％）有综合 ICU；共监测患者5887例，发生医院感染1634例、1962例次，医院感染现患率及例次现患率分别为27．76％、33．33％。医院感染部位以下呼吸道（70．39％）居首位，其次为泌尿道（12．79％）、血液（2．86％）。泌尿道插管、动静脉置管及呼吸机使用率分别达53．52％（3151例）、37．05％（2181例）、35．62％（2097例），其相关泌尿道感染、肺炎、血流感染现患率分别为4．67％、20．41％、0．60％，分别占泌尿道、肺炎、血流现患医院感染的58．57％、30．99％、23．21％，三者合计占医院感染现患率29．97％（588/1962）。检出医院感染病原体1795株，居前3位的分别是铜绿假单胞菌（20．78％）、鲍曼不动杆菌（17．99％）和肺炎克雷伯菌（11．64％）。抗菌药物使用率为71．58％（4214例），病原学送检率达75．27％（2553/3392）。结论综合 ICU 住院患者医院感染现患率以及抗菌药物使用率高，各种侵入性操作（泌尿道插管率、动静脉置管率和呼吸机使用率）高，30％的医院感染与侵入性操作相关；非发酵菌感染严重，病原学送检率尚可。
목적：료해아국의원종합중증감호실（ICU）의원감염발생솔、상견침입성조작사용솔급상관감염솔、항균약물사용급병원체분포정황。방법대2012년3월15일-12월31일기간상보지전국의원감염감측망의원감염횡단면조사자료중종합 ICU 감측수거진행회총분석。결과1313소의원중，621소（47．30％）유종합 ICU；공감측환자5887례，발생의원감염1634례、1962례차，의원감염현환솔급례차현환솔분별위27．76％、33．33％。의원감염부위이하호흡도（70．39％）거수위，기차위비뇨도（12．79％）、혈액（2．86％）。비뇨도삽관、동정맥치관급호흡궤사용솔분별체53．52％（3151례）、37．05％（2181례）、35．62％（2097례），기상관비뇨도감염、폐염、혈류감염현환솔분별위4．67％、20．41％、0．60％，분별점비뇨도、폐염、혈류현환의원감염적58．57％、30．99％、23．21％，삼자합계점의원감염현환솔29．97％（588/1962）。검출의원감염병원체1795주，거전3위적분별시동록가단포균（20．78％）、포만불동간균（17．99％）화폐염극뢰백균（11．64％）。항균약물사용솔위71．58％（4214례），병원학송검솔체75．27％（2553/3392）。결론종합 ICU 주원환자의원감염현환솔이급항균약물사용솔고，각충침입성조작（비뇨도삽관솔、동정맥치관솔화호흡궤사용솔）고，30％적의원감염여침입성조작상관；비발효균감염엄중，병원학송검솔상가。
Objective To realize the incidence of healthcare-associated infection (HAI),the rate of invasive procedure and related infection rate,use of antimicrobial agents and distribution of pathogens in gereral intensive care units (GICUs) of hospitals in China.Methods HAI cross-sectional investigation data of GICUs reported to China HAI Surveillance Net-work were summarized and analyzed.Results Of 1 313 hospitals,621(47.30%)had GICUs;a total of 5 887 patients were surveyed,1 634 patients developed 1 962 times of infection,HAI prevalence rate and case rate was 27.76% and 33.33%respectively.The main infection sites were lower respiratory tract(70.39%),urinary tract (12.79%)and blood(2.86%). The application rate of urinary catheter,arteriovenous catheter and ventilator was 53.52%(n=3 151),37.05%(n=2 181) and 35.62%(n=2 097)respectively,and related prevalence of urinary tract infection,pneumonia and blood stream infection was 4.67%,20.41%,and 0.60%,respectively,which accounting for 58.57%,30.99%,and 23.21 % of urinary tract infection,pneumonia and blood stream infection respectively,the overall prevalence of above invasive procedure-re-lated infection accounted for 29.97%(588/1 962)of the overall HAI prevalence.A total of 1 795 isolated pathogens causing HAI were detected,the top three were Pseudomonas aeruginosa (20.78%),Acinetobacter baumannii(17.99%)and Klebsiella pneumoniae (11 .64%).The usage rate of antimicrobial agents was 71 .58%(n=4 214), rate of specimens delivered for detection was up to 75.27%(2 553/3 392).Conclusion Prevalence and antimicrobial use in patients in GICUs are all high,all kinds of invasive procedure are frequent,30% of HAI are related to inva-sive procedure;infection caused by non-fermentative bacteria is serious,pathogen detection is well performed.