CAJ | 학술논문

目的：了解渝中区市属三甲医院重症医学科（ICU）医院感染的现状，分析常见病原菌及其易感原因，为降低医院感染的发生率提供指导。方法收集2013年重庆市渝中区5所医院ICU医院感染相关资料，研究其发病率、常见感染部位、常见病原菌，并分析其感染发生原因。结果2013年平均感染例次率6．58％，平均日感染发生率12．51‰；呼吸（58．91％）、泌尿（28．29％）及血液（8．91％）为常见感染系统；长时间留住ICU，疾病危重程度，高龄，使用“三管”是ICU医院感染的易感因素；对有创机械通气患者施行声门下吸引、床头抬高、早期开展肠内营养、气囊测压、洗必泰口腔护理可有效预防呼吸机相关性肺炎（VAP）的发生（P＜0．05）；铜绿假单胞菌（27．81％）、鲍曼不动杆菌（20．86％）及大场埃希菌（15．56％）为常见感染细菌，且耐药率高。结论渝中区三甲医院ICU院感率符合院感控制标准且低于全国平均水平；结合本地区特点，应重点做好VAP的预防工作，采取切断非发酵菌的传播途径、限制广谱抗菌药物的滥用等预防措施以控制ICU医院感染的发生。
목적：료해투중구시속삼갑의원중증의학과（ICU）의원감염적현상，분석상견병원균급기역감원인，위강저의원감염적발생솔제공지도。방법수집2013년중경시투중구5소의원ICU의원감염상관자료，연구기발병솔、상견감염부위、상견병원균，병분석기감염발생원인。결과2013년평균감염례차솔6．58％，평균일감염발생솔12．51‰；호흡（58．91％）、비뇨（28．29％）급혈액（8．91％）위상견감염계통；장시간류주ICU，질병위중정도，고령，사용“삼관”시ICU의원감염적역감인소；대유창궤계통기환자시행성문하흡인、상두태고、조기개전장내영양、기낭측압、세필태구강호리가유효예방호흡궤상관성폐염（VAP）적발생（P＜0．05）；동록가단포균（27．81％）、포만불동간균（20．86％）급대장애희균（15．56％）위상견감염세균，차내약솔고。결론투중구삼갑의원ICU원감솔부합원감공제표준차저우전국평균수평；결합본지구특점，응중점주호VAP적예방공작，채취절단비발효균적전파도경、한제엄보항균약물적람용등예방조시이공제ICU의원감염적발생。
Objective To investigate current situation of nosocomial infection in intensive care unit (ICU ) of municipal grade A hospital in Yuzhong district ,explore the common pathogentic bacterium and susceptible factors , and to provide advice for reducing the incidence of nosocomial infection .Methods Nosocomial infection related infor‐mation of ICU of 5 grade A hospital in Yuzhong district was collected ,and the incidence of nosocomial infection ,com‐mon sites of nosocomial infection ,common pathogentic bacterium and susceptible factors were analyzed .Results The incidence of nosocomial infections in 2013 was 6 .58% ,the incidence of nosocomial infection per patient day was 12 .51‰ .Respiratory system(58 .91% ) ,urinary system(28 .29% ) and hematological system(8 .91% ) were common sites of nosocomial infection .Long‐time stay in ICU ,severity of illness ,elder and utilization of "three‐tube"were sus‐ceptible factors of nosocomial infection .Conducting aspiration of subglottic secretion ,lifting the head of bed ,develo‐ping early enteral nutrition ,measuring pressure by the balloon technique and conducting oral care with chlorhexidine for patients under mechanical ventilation effectively prevent ventilator associated pneumonia (VAP) ,with statistical significance(P<0 .05) .Pseudomonas aeruginosa(27 .81% ) ,Acinetobacter baumannii(20 .86% ) and Escherichia coli (15 .56% ) were the most common pathogentic bacterium ,with high resistance rate .Conclusion The incidence of nosocomial infection in in ICU of municipal grade A hospital in Yuzhong district could be in line with nosocomial in‐fection control standards and could be lower than that of national average level .The prevention of VAP ,cutting off infection routes and restricting abuse of broad spectrum antibiotic could be used to control nosocomial infection .