| 蒋炬.重症监护病房导管相关院内感染发生率及多重耐药病原体流行特征研究[J].安徽医药,待发表. |
| 重症监护病房导管相关院内感染发生率及多重耐药病原体流行特征研究 |
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| 投稿时间：2026-07-04 录用日期：2026-07-30 |
| DOI： |
| 中文关键词: 重症监护病房 导管相关院内感染 呼吸机相关性肺炎 中心静脉导管相关血流感染 导尿管相关尿路感染 |
| 英文关键词: |
| 基金项目:江苏省卫健委医学科研项目（项目编号：Z2022087） |
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| 中文摘要: |
| 目的 探讨重症监护病房(ICU)导管相关院内感染的发生率及多重耐药(MDR)病原体流行特征,为优化ICU感染防控策略提供循证依据。方法 回顾性纳入2024年1月—2025年12月某三级医院ICU收治的545例成年患者,分为2024年(对照时段,n=262)与2025年(观察时段,n=283)两个队列,对比两个时段呼吸机相关性肺炎(VAP)、中心静脉导管相关血流感染(CLABSI)、导尿管相关尿路感染(CAUTI)的发生率及MDR病原体检出情况,采用Mann-Whitney U检验、卡方检验、泊松分布发生率比(IRR)进行统计学分析。结果 2024年VAP发生率为23.5/1000器械日,2025年降至17.2/1000器械日,绝对降幅27%,其中鲍曼不动杆菌所致VAP占比从39%降至17%(P=0.005)；CLABSI、CAUTI发生率呈下降趋势,但差异无统计学意义(P均>0.05)。结论 强化感染防控措施后,ICU鲍曼不动杆菌相关VAP发生率显著下降,需持续规范侵入性器械管理,巩固手卫生等基础防控措施,降低MDR病原体感染风险。 |
| 英文摘要: |
| Objective To explore the incidence of catheter-related nosocomial infections and epidemic characteristics of multidrug-resistant (MDR) pathogens in intensive care unit (ICU), and provide evidence-based basis for optimizing ICU infection prevention and control strategies. Methods A total of 545 adult patients admitted to the ICU of a tertiary hospital from January 2024 to December 2025 were retrospectively enrolled, and divided into two cohorts: 2024(control period, n=262) and 2025 (observation period, n=283). The incidence of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI) and the detection of MDR pathogens were compared between the two periods. Mann-Whitney U test, chi-square test and incidence rate ratio (IRR) of Poisson distribution were used for statistical analysis. Results The incidence of VAP was 23.5 cases per 1000 device-days in 2024, and decreased to 17.2 cases per 1000 device-days in 2025, with an absolute reduction of 27%. Among them, the proportion of VAP caused by Acinetobacter baumannii decreased from 39% to 17% (P=0.005). The incidence of CLABSI and CAUTI showed a downward trend, but the difference was not statistically significant (all P>0.05). Conclusion After strengthening infection prevention and control measures, the incidence of Acinetobacter baumannii-related VAP in ICU decreased significantly. It is necessary to continuously standardize the management of invasive devices, consolidate basic prevention and control measures such as hand hygiene, and reduce the risk of MDR pathogen infection. |
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