| OBJECTIVE1) to evaluate the incidence and the distribution of nosocomial infection in the intensive unit at our hospital.2)to evaluate the distribution of pathogens of nosocomial infection in ICU.3)According to the bacteria antimicrobial susceptibility test results, to rationally use antibiotics in ICU,and to improve treatment level of infection.4)To analyze the risk factors for nosocomial infection.5)To provide evidence for the prevention and management of nosocomial infection and individual protection of staff in ICU.SUBJECT and METHODThe 486 medical record out ICU patients were retrospectively analyzed during January～December 2010, by referring to medical record and nosocomial infection register to investigate the prevalence of nosocomial infection.The investigated content mainly include gender,age,primary diagnoses and the prognoses of the patients;location of infection,date of infection,pathogenic bacterium and drug sensitivity; risk factors,such as mechanical ventilation,arteriovenous catheter and urinary catheter, radiochemotherapy, the use of immunosuppressive agents and steroid hormone drugs,and information of using antibiotics.RESULT1) The nosocomial infection rates:Among the 486 ICU patients,119 people got the nosocomial infection(25.64%),with 171 infection cases in total(35.19%).2) Sex distribution:90 people got infection among the 301 male patients(29.90%); 29 people got infection among the 184 female patients. 3) Age distribution:The ages of the infectors were between 10 to 92 (61.52±19.37).4) The relationship between nosocomial infection and hospitalization time:The hospitalization time of the infectors were between 3 days to 40days, with an average of 7.97 days.5) The prognosis:Among the infectors,37 died(31.36%),12 were not improved(10.17%),65 were improved(55.08%), and 4 patients discharged without medical advice(3.39%).6) The distribution of nosocomial infection pathogenic site:Analysis the main pathogenesis position of these infectors, lower respiratory infection was the first(account for 62.65%), the second was urinary tract infection(account for 15.66%), and the third was abdominal cavity(account for 6.02%).7) Among 223 strains isolated from the infectors, the percentage of gram native(G—) bacteria, gram positive(G+) bacteria and fungi were 73.55%(164/223),12.12 %(27/223) and 14.36%(32/223)respectively. Acinetobacter baumannii was the major isolated bacteria among G—strains(32.74%,73/223), and the detectable rates of Pseudomonas aeruginosa and Klebsiella pneumoniae were 16.59%(37/223) and 7.17%(16/223) respectively.8) The most common pathogens of lower respiratory and abdominal cavity infections were G—bacteria, and the most common pathogens of urinary tract infection was fungi.9) The resistant rates of Acinetobacter baumannii to Cefotaxime, imipenem, meropenem, Cefepime and ceftazidime were 100%,98.61%,98.59%,98.04% and 97.06% respectively.10) In the single factor conditional logistic regression analysis,14 risk factors were selected. In the multiple factors condition logistic regression analysis,5 risk factors which were artificial airway, surgery, urinary catheter, arteriovenous catheter, and, combined use of antibiotic were selected.CONCLUSION Nosocomial infections in the Intensive Care Unit were so common that it is very important to prevent and control hospital infection. Lower respiratory infection is the first easily infected pathogenic site. The pathogens of nosocomial Infections are so many, are quite different in different sites. There are many risk factors contribute to nosocornial infection. The medical personnel should strengthen the administration of invasive procedures, and the cleaning of the wards. |
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