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发展中国家一所大学医院重症监护病房的医院感染:与国家医院感染监测重症监护病房率的比较。

Nosocomial infections in the intensive care units at a university hospital in a developing country: comparison with National Nosocomial Infections Surveillance intensive care unit rates.

作者信息

Khuri-Bulos N A, Shennak M, Agabi S, Saleh S, Al Rawashdeh S, Al Ghanem S, Al Adham M, Faori I, Abu Khader I

机构信息

Department of Pediatrics, Division of Infectious Disease, Jordan University Hospital, Amman, Jordan.

出版信息

Am J Infect Control. 1999 Dec;27(6):547-52. doi: 10.1016/s0196-6553(99)70035-0.

Abstract

OBJECTIVE

As a measure of the quality of care provided to patients in the intensive care unit, comparison of nosocomial infection rates with those of the National Nosocomial Infection surveillance was completed during a 3-year observation period.

DESIGN

The study design was a prospective study during 3 years between 1993 and 1995. During that period, patients at the medical/surgical and neurosurgical intensive care units and the high-risk nursery were surveyed for nosocomial infections. Device use, bloodstream infection, urinary tract infection, and ventilator-associated pneumonia nosocomial infection rates were calculated and compared with the National Nosocomial Infection Surveillance published rates for the same period.

SETTING

The study setting was the medical/surgical intensive care unit, the neurosurgical intensive care unit, and the high-risk nursery at the Jordan University Hospital.

RESULTS

Overall infection rates were 17.2 per 100 patients in the medical/surgical intensive care unit, 14.2 to 18.5 per 100 patients in the neurosurgical intensive care unit, and 13.4 to 73.5 per 100 patients in the high-risk nursery. When compared with the weight of the infants, these rates were 61.9 to 94 per 100 in infants weighing <1500 g, 26 to 30.8 per 100 patients in infants weighing >1500 g to 2500 g, and 11.7 to 14.4 per 100 in infants weighing >2500 g. Whereas device use was moderate, bloodstream infection and ventilator-associated pneumonia rates were >90th percentile for National Nosocomial Infection Surveillance in the high-risk nursery, and urinary tract infection was >90th percentile in the medical/surgical and neurosurgical intensive care units. Nosocomial infections at the intensive care units in developing countries need further investigation and control.

摘要

目的

作为衡量重症监护病房为患者提供护理质量的一项指标,在3年观察期内,将医院感染率与国家医院感染监测数据进行了比较。

设计

本研究设计为1993年至1995年期间的一项前瞻性研究。在此期间,对内科/外科重症监护病房、神经外科重症监护病房和高危新生儿病房的患者进行了医院感染调查。计算了器械使用、血流感染、尿路感染和呼吸机相关性肺炎的医院感染率,并与国家医院感染监测同期公布的数据进行了比较。

地点

研究地点为约旦大学医院的内科/外科重症监护病房、神经外科重症监护病房和高危新生儿病房。

结果

内科/外科重症监护病房的总体感染率为每100例患者17.2例,神经外科重症监护病房为每100例患者14.2至18.5例,高危新生儿病房为每100例患者13.4至73.5例。与婴儿体重相比,体重<1500g的婴儿感染率为每100例61.9至94例,体重>1500g至2500g的婴儿感染率为每100例患者26至30.8例,体重>2500g的婴儿感染率为每100例11.7至14.4例。尽管器械使用情况适中,但高危新生儿病房的血流感染和呼吸机相关性肺炎发生率高于国家医院感染监测的第90百分位数,内科/外科和神经外科重症监护病房的尿路感染发生率高于第90百分位数。发展中国家重症监护病房的医院感染需要进一步调查和控制。

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