Reduction of Nosocomial Pneumonia Using Surveillance and Targeted Interventions in an Algerian Neonatal Intensive Care Unit
Reduction of Nosocomial Pneumonia Using Surveillance and Targeted Interventions in an Algerian Neonatal Intensive Care Unit
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DOI：
10.1086/598337
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发表时间：
2009-07-01
影响因子：
4.5
通讯作者：
Boubechou, Nora
中科院分区：
文献类型：
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作者：
Atif, Mohamed Lamine;Sadaoui, Fetta;Boubechou, Nora
有效的监测系统已被描述为减少医院感染数量的预防措施。“在发展中国家，对新生儿重症监护病房（NICU）监测的有效性研究很少。2本研究的目的是记录医院获得性肺炎（NP）的发生率，并检查在资源有限的新生儿重症监护室（NICU）中，结合强化监测、绩效反馈和洗手教育的感染控制计划对NP发生率的影响。本研究在阿尔及利亚拥有650张床位的布利达大学医院进行。新生儿重症监护室每年收治约1，600名新生儿。它有47个住院病人的设施。新生儿重症监护室经常严重拥挤（有时，每个婴儿床有2个婴儿）。医疗管理由4名全职医务人员和实习生负责。病人和护士的比例是10：1。研究时，该NICU未使用机械通气。2004年4月至2006年12月在NICU进行了一项前瞻性监测研究。所有留在NICU超过48小时的新生儿均考虑参加本研究。感染控制医生从入院到出院每天观察所有新生儿，并记录NP病例。NP的定义改编自疾病控制和预防中心。3在我们的定义中，病原体的分离不是必需的。数据记录在预定义的表格中。所有疑似感染的新生儿的数据在输入计算机化数据库之前由所有医务人员进行审查。记录的数据包括性别、胎龄、出生体重、NICU停留时间和死亡率。在监测的第一年和第二年，鼓励使用抗菌肥皂洗手，但以非结构化的方式。在第三年年初，开展了一项全面的教育运动，以em-
Effective surveillance systems have been described as a preventive measure for reducing the number of nosocomial infections.'The efficacy of surveillance has been poorly studied in neonatal intensive care unit (NICUs) in developing countries. 2 The objectives of this study were to document the rate of nosocomial pneumonia (NP) and to examine the effect of an infection control program that combined intensive surveillance, performance feedback, and education about hand washing on the incidence of NP in an NICU with limited resources.This study was conducted at University Hospital of Blida, a large hospital in Algeria with 650 beds. The NICU admits approximately 1,600 neonates per year. It has facilities for 47 inpatients. The NICU is often seriously overcrowded (sometimes, there are 2 babies per cot). Medical management is undertaken by 4 full-time staff neonatologists and interns. The ratio of patients to nurses is 10: 1. At the time of the study, mechanical ventilation was not used in this NICU. A prospective surveillance study was performed in the NICU from April 2004 through December 2006. All neonates who remained in the NICU for more than 48 hours were considered for the study. An infection control physician observed all neonates daily from admission to the hospital until discharge and documented cases of NP. The definition of NP was adapted from the Centers for Disease Control and Prevention. 3 Isolation of a pathogen was not necessary in our definition. Data were recorded on a predefined form. Data for all neonates who were suspected of having infection were reviewed by all medical staff before they were entered into a computerized database. Recorded data included sex, gestational age, birth weight, duration of NICU stay, and mortality. In the first and second years of surveillance, hand washing with use of antimicrobial soap was encouraged, but in an unstructured manner. In the beginning of the third year, a comprehensive education campaign was undertaken to em-