目的 探讨医院综合重症监护病房(GICU)机械通气患者导管相关性血流感染(CRBSI)的病原菌特点及发生感染的相关危险因素.方法 选择2009年1月-2011年12月医院GICU182例机械通气患者为研究对象,对其导管相关性血流感染(CRBSI)的情况进行回顾性分析.结果 182例导管植入患者总置管天数5509 d,发生CRBSI25例,感染率为4.5‰;182份标本共分离出24株病原菌,其中革兰阴性杆菌12株,占50.0％,革兰阳性球菌8株,占33.3％,真菌4株,占16.7％,排名前4位病原菌依次为鲍氏不动杆菌、白色假丝酵母菌、金黄色葡萄球菌、阴沟肠杆菌,分别占29.2％、16.7％、12.5％、12.5％.结论 机械通气患者CRBSI以革兰阴性杆菌为主,与患者的病情危重程度、留置导管时间和医务人员缺乏较强的手卫生执行力有关.

OBJECTIVE To reduce the incidence of infections at the outlet of central venous catheter(cvc) in ICU.METHODS A retrospective survey was performed in Group A by reviewing the medical records of discharged patients and completing a record form item by item;targeted surveillance was performed in Group B by 2 professional nurses in charge of deep venous catheter.Through a series of measures for control of infections,the data of 2 groups were statistically analyzed.RESULTS The rate of the infections of catheter outlet of group A was 25.5‰;after the implementation of targeted monitoring and various measures for control of infections,the rate of infections of catheter outlet decreased to 5.8‰,the difference was statistically significant(P0.01).CONCLUSION Among the comprehensive control measures,to intensify the training of medical staff,set a professional nurse team to monitor the quality of central venous catheterization during the whole process,and establish the procedure of prevention and control of cvc-associated infections are very effective ways to reduce the infections of central venous catheter outlet.

OBJECTIVE To reduce the incidence of catheter-related bloodstream infections.METHODS A retrospective survey was performed to Group A by searching for discharged patients and completing a record sheet item by item.A targeted surveillance to Group B was performed,There were two full-time care nurses in charge of specific operations on central venous catheter by adopting a series of infection control measures,the data of the two groups were aggregated statistics,analyzed and judged,the infection rates were calculated and compared.RESULTS The catheter-related bloodstream infection rate of group A was 20.9‰,Group B took the method of targeted survey and implemented measures of infection control,the catheter-related bloodstream infection rate fell to 5.4 ‰,it was significantly different(P0.05).CONCLUSION In the comprehensive control measures,it is a very effective measure of setting professional nursing team on the whole process of quality management on central venous catheter tube and improving the technical level and execution of the doctors and nurses in the medical activities to reduce the catheter-related bloodstream infections.