ICU导管相关感染监测课件

ICU导管相关感染监测

(Aversionfortrainingpurposeonly,thedatainvolvedisnotreflectingtherealsituation)Surveillanceof

DeviceRelatedInfection

inIntensiveCareUnit

NationalNosocomialInfectionsSurveillance(NNIS)system

全国院内感染监测系统Purpose目的Monitortheinfectionrates监控感染率BenchmarkwithNNISSystem与NNIS标竿Determinetrends确定趋势Identifyoutbreak定义暴发Facilitatecomparisons易于比较Linkmonitoredratesandpreventionefforts感染率与预防效果的联系Reducedevicesrelatedinfectioninhospital减少医院导管等装置的感染率Device-associatedinfections导管相关感染Urinarycatheter-associatedUrinarytractinfection(CA-UTI)导尿管相关的尿路感染Centralline-associatedBloodstreaminfection(CA-BSI)中心静脉导管相关的血流感染Ventilator-associatedPneumonia(VAP)呼吸机相关的肺炎Denominatordata分母资料Countat12midnightineveryday每天在午夜12点计算Totalnumberofpatients’admission所有病人Patient-days病人日Urinarycatheter-days导尿管日Centralline-days中心静脉插管日Ventilator-days呼吸机日Surveillancemethods调查方法ongoingrevieweachpatientinICU.持续观察ICU的每个病人byreviewingDoctorsprogressnotes,Nursingnotes,

Physiotherapistsnotes,XRreport,charts,MARforms,conversationswithnursesandphysicians查看医生病程、护理记录、理疗单、X线检查、CT/MAR。医生护士的会话byreviewinglaboratorydata.

查看实验室数据

Definedevice-relatedinfection定义导管相关感染ByusingstandardCDCdefinitionsthatincludelaboratory&clinicaldata使用CDC的标准包括实验室和临床资料Definitions–CA-BSIHaddevicewithin48-hrsperiodbeforeonsetofinfectionClinicalmanifestationsCommonskincontaminantfrom2bloodculturesNoapparentsourceforBSIexceptthecatheterDefinitions–CA-UTISymptomaticUTIS/SofUTI+veurineculture>=10Asymptomaticbacteriuria+veurineculture>=10NoS/SofUTICalculateDevice-associatedinfectionratesNumberofdevice-associatedinfectionforaspecificsitex1000Numberofdevice-daysVAPSurveillanceinICU

A BNo.ofVAP 6 27Patientdays 1373 4872Ventilatordays 643 2694Infectionrates 9.33(>50) 10.02(>50)DUratios 0.47[50] 0.55[75]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentileCA-BSISurveillanceinICU

A BNo.ofCA-BSI 0 8Patientdays 1373 4872CVCdays 402 3216 Infectionrates 0(10) 2.49(25)DUratios 0.26[>10] 0.66[50]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentileCA-UTISurveillanceinICU A BNo.ofUTI 23 12Patientdays 1373 4872UrinaryCathdays 1148 4711Infectionrates 20.03(>90)2.55(25)DUratios 0.84[50] 0.97[.90]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentilePathogensIsolated–CA-UTI

No.ofinfection 23No.ofisolate 28GM-vemicroorganism 92.9% E.Coli(50%),Klebsiella(14.3%),P