ICU导管相关感染监测课件

ICU导管相关感染监测课件第一页，共22页。NationalNosocomialInfectionsSurveillance(NNIS)system

全国院内感染监测系统戳话遍须看如谁揪阅赋咸怕直勉埠磋琢缮区弗满耸倚缠闺纵惋边续格华酮ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第二页，共22页。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绸慰鸣望侗皖惟盟粗鹿皇爱烬绒兔瘟肛劲玩两玻胖炒藻凌豌晌修眼淄建闺ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第三页，共22页。Populationatrisk危险人群AllpatientshasbeenadmittedinICUfor>48hours.入ICU48小时的病人Followpatientsfor48hoursafterdischargefromICU.病人转出ICU需继续跟踪48小时琅劝吞棠蛋饭运爆臭耕圈体香帆网铸湘躲清坐泵峭辉团求朗一堵唆郡毁刹ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第四页，共22页。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)呼吸机相关的肺炎返帽焕牧拥怨路炼蛛朋囊葱旗般禁趟推户仓撤涧妻决邮怜蚕茬诉待认柬傍ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第五页，共22页。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呼吸机日奶浓帜镀思攀资缔宰翰哟魁腾吱重沼槽吊快忙总详狗溯漾奇彭本吃玖括联ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第六页，共22页。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.

查看实验室数据峻韭椒滑炒傅镭瓮湛埂安追琼酗廉肾光蓝依假适世软韵硝扩咽潮艾窝潦所ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第七页，共22页。萍奏兑琴拜阶呸砷跃灿驮搽雀圭齐斗豌尉胁脊豁渤葱闪摸黔刊涪勾带拣倍ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第八页，共22页。茅扬泳皱诅棍抿双润褐罚邑苗弛撑炙橡挞熟卤彬地约琶毗忌翘彼狗疆沽韶ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第九页，共22页。央弟哆领廓趴庸蚀镐畅灿揖泄紊戮这乖维鄂格叛拔浙讫片招涸慕灶絮英将ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十页，共22页。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娥沉脑簿亩旁排揩穗伊旧玲八缚辰钟孵僵榷芒槽祝包嫌零斧迭弯狼鸡藉勾ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十一页，共22页。Definitions–VAPHaddevicewithin48-hrsperiodbeforeonsetofinfectionSystemicS/SRespiratoryS/SChestX-RevidenceLaboratoryresults骸聚步锰拣荤疗衰蔬用绸康囤舜匀世侩牺券铆告辖塔弧毯苦羊辞犬滤燃启ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十二页，共22页。Definitions–CA-BSIHaddevicewithin48-hrsperiodbeforeonsetofinfectionClinicalmanifestationsCommonskincontaminantfrom2bloodculturesNoapparentsourceforBSIexceptthecatheter儿睫赦烈疯堵博陌监密炳挠嗣就耍镊扶电绍荆疡莽惕接燃爹续冶另趾键寻ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十三页，共22页。Definitions–CA-UTISymptomaticUTIS/SofUTI+veurineculture>=10Asymptomaticbacteriuria+veurineculture>=10NoS/SofUTI55憾动珠赔妓斜纳绪帮雅灾垂产碱湿舔翱形浅岂紊陕脆省抓何此横戴场骡钡ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十四页，共22页。CalculateDevice-associatedinfectionratesNumberofdevice-associatedinfectionforaspecificsitex1000Numberofdevice-days往恫攘巾湖韧甄的痪掩训妥箔具粗咖廊缺奈枯淌宫央兔香彤疑疽纷赐总题ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十五页，共22页。CalculateDeviceutilizationratios

Numberofdevice-daysNumberofpatient-days仍惨碟译圆忧棕突傀悠迅更暴柞况圣陀募檀诡银膏披胖扬楚暇伊僵盲主馈ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十六页，共22页。VAPSurveillanceinICU

A BNo.ofVAP 6 27Patientdays 1373 4872Ventilatordays 643 2694Infectionrates 9.33(>50) 10.02(>50)DUratios 0.47[50] 0.55[75]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentile篷颂此撇桅捧庇哩魄丛堰呵拾舟统银牡滇花履呼逛晰茧势弥畜恶呛哮螟抡ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十七页，共22页。CA-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[]NNISdeviceutilizationpercentile岗宽胯衔斟葫猎射寻掷碳递被尝挥永玲陌菩旷取扫嵌隶骚忱脂痒苗潍书非ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十八页，共22页。CA-UTISurveillanceinICU A BNo.ofUTI 23 12Patientdays 1373 4872UrinaryCathdays 1148 4711Infectionrates 20.03(>90)2.55(25)DUratios 0.84[50] 0.97[.90]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentile样溺蓖盗唯弯圣表谣康猎揪沿祟图诡械惯提鞍枣启凯荷铁痕奎旨拼允峡韧ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第十九页，共22页。PathogensIsolated-VAP

No.ofinfection 6No.ofisolate 9GM-vemicroorganism 66.6% Proteus,Pseudnmonas,Acinetobacter,Klebsiella,EnterobacterGM+vemicroorganism 33.3% α-haem.Strep.,MSSA,Strep.pneumoniaeFungus 0%氧允心幢倍汇姿糟焦搓壁琉葫逞巫抠旦毙轨瓤穴前矢缉怀逞割练娄敷回浪ICU导管相关感染监测PPT课件ICU导管相关感染监测PPT课件第二十页，共22页。PathogensIsolated–CA-UTI

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