Prevalence of infections in intensive care units in Mexico:: A multicenter study
Prevalence of infections in intensive care units in Mexico:: A multicenter study
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DOI：
10.1097/00003246-200005000-00010
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发表时间：
2000-05-01
影响因子：
8.8
通讯作者：
Vázquez-Ramos, VG
中科院分区：
文献类型：
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作者：
de León-Rosales, SP;Molinar-Ramos, F;Vázquez-Ramos, VG
目的：确定墨西哥ICU中社区获得性、医院获得性或重症监护病房（ICU）获得性感染的1天患病率。确定相关危险因素、主要感染微生物和死亡率。设计：为期1天的点患病率研究。环境：墨西哥共有254个成人icu。患者：参与icu住院的成年患者。结果：共调查895例患者，其中521例（58.2%）感染。社区获得性感染214例（23.9%），非icu院内感染99例（11.1%），至少发生一次icu内获得性感染208例（23.2%，1.45次/例）。最常见的icu获得性感染是肺炎（39.7%）、尿路感染（20.5%）、伤口感染（13.3%）和菌血症（7.3%）。随访6周后icu获得性感染死亡率为25.5%。多因素回归分析显示icu获得性感染的危险因素如下：神经功能衰竭是入院的主要原因（优势比[OR]， 1.697； 95%可信区间[GI]， 1.001-2.839）；ICU住院时间（OR, 1.119; 95% CI, 1.091-1.151）；前一周的治疗和/或诊断干预次数（or, 1.118; 95% CI, 1.016-1.231）；外周输注高渗溶液（OR, 6.93; 95% CI, 2.452-21.661）；前一周的镇静剂使用情况（OR, 1.751; 95% CI, 1.183-2.602）；前一个月有急诊手术史（OR, 1.875; 95% CI, 1.251-2.813）。如果存在感染，给予抗菌药物治疗可降低死亡风险（OR, 0.406; 95% CI, 0.204-0.755）。结论：发现了医院感染高频率的证据，并确定了获得感染和死亡的潜在危险因素。死亡率根据等级的系统性炎症反应综合征在拉丁美洲icu报告。
Objective: To determine the 1-day prevalence of community-acquired,hospital-acquired, or intensive care unit (ICU)-acquired infections in Mexican ICUs. To identify associated risk factors, predominant infecting organisms, and mortality rates.Design: A 1-day point-prevalence study.Setting: A total of 254 adult ICUs in Mexico.Patients: Adult patients hospitalized in the participating ICUs.Results: A total of 895 patients were studied, of whom 521 patients (58.2%) were infected. community-acquired infection occurred in 214 patients (23.9%), non-ICU nosocomial infection occurred in 99 patients (11.1%), and 208 patients had at least one ICU-acquired infection (23.2%; 1.45 episodes/patient). The most frequently reported ICU-acquired infections were pneumonia (39.7%), urinary tract infections (20.5%), wound infection (13.3%), and bacteremia (7.3%). The mortality rate for the ICU-acquired infections after 6 wks of follow-up was 25.5%. Multivariate regression analysis showed the following risk factors for ICU-acquired infections: neurologic failure as a primary cause of admission (odds ratio [OR], 1.697; 95% confidence interval [GI], 1.001-2.839); length of stay in ICU (OR, 1.119; 95% CI, 1.091-1.151); number of therapeutic and/or diagnostic interventions during the preceding week (OR, 1.118; 95% CI, 1.016-1.231); peripherally administered infusion of hyperosmolar solutions (OR, 6.93; 95% CI, 2.452-21.661); sedative usage in the preceding week (OR, 1.751; 95% CI, 1.183-2.602); history of an emergency surgery in the preceding month (OR, 1.875; 95% CI, 1.251-2.813). The administration of antimicrobial treatment if there was an infection decreased the risk of death (OR, 0.406; 95% CI, 0.204-0.755).Conclusions: Evidence of a high frequency of nosocomial infections was found, and potential risk factors for acquiring infections and mortality were identified. Mortality rates according to the hierarchy of the systemic inflammatory response syndrome in Latin American ICUs are reported.