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1、Surveillance ofDevice Related Infection in Intensive Care Unit ICU导管相关感染监测 (A version for training purpose only, the data involved is not reflecting the real situation )ICU-导管相关感染调查National Nosocomial Infections Surveillance (NNIS) system全国院内感染监测系统ICU-导管相关感染调查Purpose目的Monitor the infection rates 监控感
2、染率Benchmark with NNIS System 与NNIS标竿Determine trends 确定趋势Identify outbreak 定义暴发Facilitate comparisons 易于比较Link monitored rates and prevention efforts 感染率与预防效果的联系Reduce devices related infection in hospital 减少医院导管等装置的感染率ICU-导管相关感染调查Population at risk 危险人群 All patients has been admitted in ICU for 48
3、hours. 入ICU48小时的病人Follow patients for 48 hours after discharge from ICU. 病人转出ICU 需继续跟踪48小时ICU-导管相关感染调查Device-associated infections 导管相关感染Urinary catheter-associated Urinary tract infection (CA-UTI) 导尿管相关的尿路感染Central line- associated Bloodstream infection (CA-BSI) 中心静脉导管相关的血流感染Ventilator- associated
4、Pneumonia (VAP) 呼吸机相关的肺炎ICU-导管相关感染调查Denominator data 分母资料Count at 12 midnight in everyday 每天在午夜12点计算Total number of patients admission 所有病人Patient-days 病人日Urinary catheter-days 导尿管日Central line-days 中心静脉插管日Ventilator-days 呼吸机日ICU-导管相关感染调查Surveillance methods 调查方法调查方法on going review each patient in I
5、CU. 持续观察ICU的每个病人by reviewing Doctors progress notes, Nursing notes, Physiotherapists notes, XR report, charts, MAR forms, conversations with nurses and physicians 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by reviewing laboratory data. 查看实验室数据 ICU-导管相关感染调查ICU-导管相关感染调查ICU-导管相关感染调查ICU-导管相关感染调查Define device-re
6、lated infection 定义导管相关感染定义导管相关感染By using standard CDC definitions that include laboratory & clinical data使用CDC的标准包括实验室和临床资料ICU-导管相关感染调查Definitions VAPHad device within 48-hrs period before onset of infection Systemic S/SRespiratory S/SChest X-R evidenceLaboratory resultsICU-导管相关感染调查Definitions CA-BS
7、I Had device within 48-hrs period before onset of infectionClinical manifestationsCommon skin contaminant from 2 blood culturesNo apparent source for BSI except the catheterICU-导管相关感染调查Definitions CA-UTI Symptomatic UTIS/S of UTI+ve urine culture =10Asymptomatic bacteriuria+ve urine culture =10No S/
8、S of UTI55ICU-导管相关感染调查Calculate Device-associated infection ratesNumber of device-associated infection for a specific site x 1000Number of device-daysICU-导管相关感染调查Calculate Device utilization ratios Number of device-daysNumber of patient-daysICU-导管相关感染调查VAP Surveillance in ICUABNo. of VAP627Patient d
9、ays13734872Ventilator days 6432694Infection rates9.33 (50) 10.02 (50)DU ratios0.47 500.55 75() NNIS device associated infection percentile NNIS device utilization percentileICU-导管相关感染调查CA-BSI Surveillance in ICU ABNo. of CA-BSI 08Patient days13734872CVC days4023216Infection rates0 (10)2.49(25)DU rat
10、ios0.26 10 0.6650() NNIS device associated infection percentile NNIS device utilization percentileICU-导管相关感染调查CA-UTI Surveillance in ICUABNo. of UTI2312Patient days13734872Urinary Cath days11484711Infection rates20.03 (90)2.55(25)DU ratios0.84 500.97.90() NNIS device associated infection percentile
11、NNIS device utilization percentileICU-导管相关感染调查Pathogens Isolated - VAPNo. of infection6No. of isolate9GM -ve microorganism66.6%Proteus, Pseudnmonas, Acinetobacter, Klebsiella, EnterobacterGM +ve microorganism33.3%-haem. Strep., MSSA, Strep. pneumoniaeFungus0%ICU-导管相关感染调查Pathogens Isolated CA-UTINo. of infection23No. of isolate28GM -ve microorganism 92.9%E.Coli (50%), Klebsiella (14.3%), Proteus (14.3%),Enterobacter (10.7%), M. morganii (3.6%)GM +ve microorganism 3.6%Enterococcus spp. Fungus3.6%Candida albicansICU-导管相关感染调查Thank youICU-导管相关感染调查
