| Objective: To understand the current situation and characteristics of nosocomial infection in a three-level general hospital intensive care unit(ICU).To analyze the main risk factors of nosocomial infection in ICU,and to provide scientific basis for intervening measures to reduce nosocomial infection.Methods: A retrospective survey and a prospective goal-monitoring approach were used to retrospectively analyze the data for2012-2014,and the data for 2015 were monitored using a forward-looking approach to collect data from January 2012 to December 2015.All the ICU patients discharged from the general hospital in the third grade were monitored,and the data were analyzed statistically.Results: 1)Among the 1,566 ICU patients surveyed from 2012 to 2015,there were 1017 males and 549 females.Of the 1,566 ICU patients,230 were catheter-related infections,159 were male and 71 were female.The infection rate of male was 16.63%Was 12.93%.There was significant difference in the rate of catheter-related infection between male and female.2)From the age distribution,the incidence of catheter-related infection in patients with a minimum age of 22 years old,the maximum age of 98 years,mean age 68.72 ± 17.74 years,high-fat age concentrated in the 71-90 years old,accounting for 56.96%;3)There were 113 cases of ventilator-associated pneumonia(VAP),accounting for 38.18%,94 cases of catheter-related urinary tract infection(CAUTI),31.76% of deep venous catheter-related bloodstream infection(CLABSI)23cases,accounting for 7.77%,65 cases of other infections,accounting for 21.96%;4)The incidence of nosocomial infection in ICU from 2012 to 2015,was 20.91%,16.12%,19.95% and 18.63%,with an average of 18.90%.There was no significant difference in overall hospital infection rate between the two groups(?2=3.121,P>0.05);5)The use rate of the three kinds of catheters were indwelling catheter(73.12%),ventilator(49.44%)and central venous catheter(35.15%).The incidence of catheter-related thousand-dayinfection was 14.09‰ for ventilator-associated pneumonia,7.93‰ for catheter-related urinary tract infection,and 4.04‰ for catheter-related bloodstream infection.(?2=9.591,P <0.05).The infection rate of ICU catheter-related cases in different years was compared between two years,and the infection rates of ICU catheter-related cases in four years were statistically significant;The difference was statistically significant;6)In the classification of basic diseases,the top four diseases were 36.96%,followed by cerebral hemorrhage 15.65%,cerebral infarction 13.91%,respiratory failure 13.04%;7)In the distribution of pathogenic bacteria,mainly gram-negative bacteria(68.26%),followed by gram-positive bacteria(20.43%)and fungi(11.30%).The top three pathogens were Klebsiella pneumoniae,Acinetobacter baumannii,Escherichia coli;8)Factors such as diabetes mellitus,coma,catheterization time,length of hospital stay,deep venous catheterization and endotracheal intubation were the main risk factors of ICU-related nosocomial infection in multivariate analysis.Conclusion: ICU patients due to the higher age,critical condition,long hospital stay,long-term use of antibiotics and a variety of invasive operation more,resulting in the body resistance and immune function is relatively low[8].Therefore,ICU compared with other departments,the hospital infection rate will be higher,but also led to the decline in the cure rate and mortality.Therefore,ICU catheter-related nosocomial infection is an urgent problem to be solved.Strictly carry out non-Yin operation,improve the general condition of patients,enhance resistance,strengthen ICU ward hospital infection surveillance and management,is to reduce the crowd catheter-related infection key. |
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