徐子琴, 张雪良. 我国重症医学科医院感染暴发的流行特征和应对策略[J]. 疾病监测, 2020, 35(10): 953-956. DOI: 10.3784/j.issn.1003-9961.2020.10.017
引用本文: 徐子琴, 张雪良. 我国重症医学科医院感染暴发的流行特征和应对策略[J]. 疾病监测, 2020, 35(10): 953-956. DOI: 10.3784/j.issn.1003-9961.2020.10.017
Ziqin Xu, Xueliang Zhang. Epidemiology and control measures of nosocomial infection outbreaks in ICU in China[J]. Disease Surveillance, 2020, 35(10): 953-956. DOI: 10.3784/j.issn.1003-9961.2020.10.017
Citation: Ziqin Xu, Xueliang Zhang. Epidemiology and control measures of nosocomial infection outbreaks in ICU in China[J]. Disease Surveillance, 2020, 35(10): 953-956. DOI: 10.3784/j.issn.1003-9961.2020.10.017

我国重症医学科医院感染暴发的流行特征和应对策略

Epidemiology and control measures of nosocomial infection outbreaks in ICU in China

  • 摘要:
    目的了解我国重症医学科(ICU)医院感染事件的流行特征,为实施针对性的感染预防控制措施提供参考依据。
    方法通过文献检索,对2010年1月至2018年12月国内报道的ICU医院感染暴发事件进行回顾性分析,使用Excel软件对感染暴发事件医院的等级、暴发时间与地点、涉及人员、感染部位、危险因素、病原菌、传播途径、易感人群等进行汇总统计。
    结果医院感染暴发事件共45起,感染359人,以三甲医院(71.11%,32/45)、夏季(33.33%,15/45)和综合ICU感染人数最多(82.23%,37/45);感染部位以下呼吸道感染为主(77.78%,35/45);病原菌最多的是鲍曼不动杆菌(65.11%,28/43),其次是金黄色葡萄球菌(11.63%,5/43),多重耐药菌高达93.02%(40/43);以间接接触传播为主,其中仪器设施设备污染共21起,医务人员手污染16起,患者环境污染15起,医用织物污染13起。 外环境采样标本目标病原菌阳性率为10.76%(209/1 943)。
    结论ICU医院感染暴发事件以接触传播为主,可能有多种传播来源,需重视多重耐药菌防控,强化防控措施,不能过度依赖外环境采样结果。

     

    Abstract:
    ObjectiveTo understand the epidemiological characteristics of outbreaks of nosocomial infection in intensive care units (ICUs) in hospitals in China and provide evidence for the prevention and control of nosocomial infection.
    MethodsThrough literature retrieval, the outbreaks of nosocomial infection in ICUs in hospitals in China reported from January 2010 to December 2018 were analyzed retrospectively. Excel was used for the statistical analyses on hospital grade, outbreak time and place, involved person, infection site, risk factor, pathogen, transmission route and susceptible population.
    ResultsA total of 45 outbreaks of nosocomial infection in ICUs were recorded, involving 359 patients, in which 32 (71.11%) occurred in grade Ⅲ (A) hospitals, 15 (33.33%) occurred in summer, 37 (82.23%) occurred in general ICUs and 35 (77.78%) had lower respiratory tract infections. Acinetobacter baumannii was major pathogen (65.11%, 28/43), followed by methicillin-resistant Staphylococcus aureus infection (11.63%, 5/43). In the pathogens, 93.02% (40/43) were multi-drug resistant. Most nosocomial infections were caused by indirect transmission, in which 21 were associated with contaminated medical devices, 16 with contaminated hands of medical staff, 15 with contamination of patient areas and 13 with contaminated medical textiles. The positive rate of conventional culture of environment samples was 10.76% (209/1 943).
    ConclusionThe contact transmissions with multiple resources were dominant among the outbreaks of nosocomial infections in ICUs in China. It is necessary to pay close attention to multi-drug resistant pathogens and strengthen prevention and control of nosocomial infection outbreaks, and do not overly depend on the results of samples from environments.

     

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