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目的调查分析ICU医院感染率、病原菌检出分布及危险因素,为预防控制ICU医院感染提供参考。方法对2012年1-6月ICU患者进行目标性监测,将住院>48h的患者作为研究对象,应用logistic回归分析ICU医院感染危险因素。结果共收集病例199例,感染79例、150例次,感染率为39.7%、例次感染率为75.4%;送检标本主要为痰标本,鲍氏不动杆菌检出率最高,耐亚胺培南鲍氏不动杆菌、铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌、产ESBLs肺炎克雷伯菌耐药率分别为94.2%、76.9%、73.9%和100.0%;单因素分析显示,住ICU天数、使用免疫抑制剂、抗菌药物、留置引流管、使用呼吸机、APACHEⅡ评分均与ICU医院感染有关(P<0.05),logistic回归分析显示,住ICU天数(P<0.01,OR=3.457)、抗菌药物使用(P=0.005,OR=1.756)是ICU医院感染的独立危险因素。结论进一步加强ICU医院感染管理与控制,严格掌握抗菌药物使用指征,尽量缩短ICU住院时间,能有效降低感染发生率。
Objective To investigate and analyze the ICU hospital infection rate, distribution and risk factors of pathogen detection, and provide reference for prevention and control of ICU nosocomial infection. Objective To monitor the ICU patients from January to June in 2012, and to study the risk factors of ICU nosocomial infection by using logistic regression analysis. Results A total of 199 cases were collected, including 79 cases and 150 cases. The infection rate was 39.7% and the infection rate was 75.4%. The specimens were mainly sputum and Acinetobacter baumannii, The antibiotic resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and ESBLs-producing Klebsiella pneumoniae were 94.2%, 76.9%, 73.9% and 100.0%, respectively. Univariate analysis The results showed that the number of ICU days, immunosuppressive agents, antibiotics, indwelling drainage tube, ventilator and APACHEⅡwere all related to ICU nosocomial infection (P <0.05). Logistic regression analysis showed that ICU days (P <0.01, OR = 3.457). Antimicrobial use (P = 0.005, OR = 1.756) was an independent risk factor for ICU nosocomial infection. CONCLUSIONS To further strengthen the management and control of ICU nosocomial infections, strictly control indications for antimicrobial use, minimize ICU length of hospital stay and effectively reduce the incidence of infections.