Vosylius S, Sipylaite J, Ivaskevicius J
Clinic of Anaesthesiology and Intensive Care, Vilnius University, Vilnius University Emergency Hospital, Lithuania.
Acta Anaesthesiol Scand. 2003 Oct;47(9):1132-7. doi: 10.1034/j.1399-6576.2003.00230.x.
Severe infection is a common reason for intensive care and contributes to increased morbidity and mortality. The aim of the study was to determine the prevalence of infection among intensive care unit (ICU) patients and to evaluate the consequences of ICU-acquired infection on morbidity and mortality.
A total of 812 patients consecutively admitted for more than 48 h to the ICU at Vilnius University Emergency Hospital, Lithuania, were included in the prospective observational study. Organ dysfunction was assessed using the Sequential Organ Failure Assessment (SOFA) system.
Thirty-seven per cent of patients were identified who developed at least one ICU-acquired infection. Respiratory, bloodstream and urinary tract infections were the most common. The main isolates were coagulase-negative Staphylococcus, S. aureus, Acinetobacter and Pseudomonas species. More severe degree of organ dysfunction, prolonged stay in the ICU and higher hospital mortality rate were more common among patients who acquired infection in the ICU than that of non-infected patients.
The prevalence of infection in the ICU was similar to other studies in European countries. The occurrence of ICU-acquired infection was significantly related to the increase in morbidity and mortality. The findings are useful for the comparison of the prevalence rate of infection and implementation of strict infection control policy.
严重感染是重症监护的常见原因，会导致发病率和死亡率上升。本研究的目的是确定重症监护病房（ICU）患者的感染患病率，并评估ICU获得性感染对发病率和死亡率的影响。
立陶宛维尔纽斯大学急诊医院共有812例连续入住ICU超过48小时的患者被纳入前瞻性观察研究。使用序贯器官衰竭评估（SOFA）系统评估器官功能障碍。
37%的患者被确定发生了至少一种ICU获得性感染。呼吸道、血流和尿路感染最为常见。主要分离菌为凝固酶阴性葡萄球菌、金黄色葡萄球菌、不动杆菌和假单胞菌属。与未感染患者相比，在ICU获得感染的患者中，器官功能障碍程度更严重、在ICU停留时间延长和医院死亡率更高的情况更为常见。
ICU的感染患病率与欧洲国家的其他研究相似。ICU获得性感染的发生与发病率和死亡率的增加显著相关。这些发现有助于比较感染患病率，并实施严格的感染控制政策。
