Nosocomial infections in a medical-surgical intensive care unit
Nosocomial infections in a medical-surgical intensive care unit
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DOI：
10.1159/000141500
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发表时间：
2008-01-01
影响因子：
3.2
通讯作者：
Al Asar, El Sayed M.
中科院分区：
文献类型：
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作者：
Aly, Nasser Yehia A.;Al-Mousa, Haifaa H.;Al Asar, El Sayed M.
目的：了解成人外科重症监护病房(ICU)的医院感染情况。对象和方法：对科威特法瓦尼亚医院15张病床的成人内外科ICU的医院感染监测进行了为期两年的前瞻性队列研究。数据是在2004年1月至2005年12月期间使用国家医院感染监测系统ICU监测部分的标准监测方案和医院感染地点定义收集的。结果：在ICU住院的1173例患者中，89例共发生医院感染140例，其中呼吸机相关性肺炎46例(33%)，中枢血流感染33例(24%)，导管相关性尿路感染15例(11%)，皮肤感染22例(16%)，其他感染24例(17%)。总的病人日率为20.6/1000病人日。患者感染率为10.6/100高危患者。VAP发生率为9.1/1000(95%CI，5~13.2)，中线相关血流感染率5.5/1000(95%CI，3.2~7.8)，导管相关尿路感染率2.3/1000导管(95%CI，1.2~3.4)。在所有医院感染中，119例(85%)是培养确认的，21例(15%)是临床确定的培养阴性感染。在培养证实的医院感染中，81例(68%)为革兰氏阴性菌，32例(27%)革兰氏阳性菌，6例(5%)真菌。最常见的病原菌为铜绿假单胞菌(20株，17%)，其次为鲍曼不动杆菌(15株，13%)、克雷伯氏菌。(13，11%)和大肠埃希菌(10.8%)。ICU感染患者的粗死亡率为27%。结论：呼吸机相关性肺炎是ICU最常见的医院感染。革兰氏阴性菌是ICU感染的常见病原菌。版权所有(C)2008 S.Karger AG，巴塞尔。
Objective: We aimed to describe the pattern of nosocomial infections in an adult medical-surgical intensive care unit (ICU). Subjects and Methods: A 2-year prospective cohort study of nosocomial infection surveillance in a 15-bed adult combined medical and surgical ICU of Farwaniya Hospital, Kuwait, was carried out. Data were collected between January 2004 and December 2005 using the standard surveillance protocols and nosocomial infection site definitions of the National Nosocomial Infections Surveillance System's ICU surveillance component. Results: Of 1,173 patients hospitalized in the ICU for an aggregate duration of 6,855 days, 89 patients acquired a total of 140 nosocomial infections; 46 (33%) ventilator-associated pneumonia (VAP), 33 (24%) centralline-associated bloodstream infection and 15 (11%) catheter-associated urinary tract infection, 22 (16%) cutaneous infection and 24 (17%) other infections. The overall patient day rate was 20.6/1,000 patient days. The patient infection rate was 10.6/100 patients at risk. The mean VAP rate was 9.1/1,000 ventilator days (95% CI, 5-13.2), the central-line-associated bloodstream infection rate 5.5/1,000 central line days ( 95% CI, 3.2-7.8) and the catheter-associated urinary tract infection rate 2.3/1,000 catheter days ( 95% CI, 1.2-3.4). Of all nosocomial infections, 119 (85%)were culture-confirmed and 21 (15%) were clinically defined culture-negative infections. Of the culture-confirmed nosocomial infections, 81 (68%) were Gram-negative, 32 (27%) Gram-positive and 6 (5%) fungal. The most frequent organism was Pseudomonas aeruginosa (20, 17%), followed by Acinetobacter baumannii (15, 13%), Klebsiella spp. (13, 11%) and Escherichia coli (10, 8%). The crude mortality was 27% among ICU-infected patients. Conclusion: VAP was the most common nosocomial infection in our ICU. Gram-negative organisms were more commonly reported as etiologic agents of ICU infections. Copyright (c) 2008 S. Karger AG, Basel.