Zolldann D, Thiex R, Häfner H, Waitschies B, Lütticken R, Lemmen S W
Dept. of Infection Control, Aachen University Hospital, 52074 Aachen, Germany.
Infection. 2005 Jun;33(3):115-21. doi: 10.1007/s15010-005-3070-3.
We assessed data on the epidemiology of nosocomial infections (NIs) in a 14-bed neurosurgical intensive care unit (NSICU) and used surveillance data for the promotion of quality improvement activities.
Prospective periodic surveillance was performed over five 3-month periods between July 1998 and October 2002 on all patients admitted with a length of stay > 24 hours.
763 patients with a total of 4,512 patient days and a mean length of stay of 5.9 days were enrolled within the 15-month study period. A total of 93 NIs were identified in 82 patients. Urinary tract infections (24.7%), pneumonia (23.6%), and bloodstream infections (17.2%) were the most frequent NIs recorded. Device-associated incidence rates were 6.0 (3.8-9.0, CI(95%)) for urinary tract infection, 4.4 (2.4-7.4, CI(95%)) for bloodstream infection, and 10.3 (6.3-15.9, CI(95%)) for pneumonia per 1,000 days at risk. For improvement of infection control-related processes, evidence-based infection control guidelines were established and an NSICU nurse was designated to be responsible for infection control issues on the ward. In addition, several infection control problems arose during the observation periods and were rapidly responded to by introducing specific intervention strategies.
Periodic surveillance is a valuable tool for assessing the epidemiology of NIs in the NSICU setting as well as for promoting the initiation of quality improvement activities.
我们评估了一家拥有14张床位的神经外科重症监护病房（NSICU）中医院感染（NI）的流行病学数据，并利用监测数据促进质量改进活动。
在1998年7月至2002年10月期间的五个为期3个月的时间段内，对所有住院时间超过24小时的患者进行前瞻性定期监测。
在15个月的研究期内，共纳入763例患者，总计4512个患者住院日，平均住院时间为5.9天。在82例患者中总共识别出93例医院感染。记录到的最常见医院感染为尿路感染（24.7%）、肺炎（23.6%）和血流感染（17.2%）。每1000个危险日中，与器械相关的尿路感染发病率为6.0（3.8 - 9.0，95%置信区间），血流感染为4.4（2.4 - 7.4，95%置信区间），肺炎为10.3（6.3 - 15.9，95%置信区间）。为改进与感染控制相关的流程，制定了循证感染控制指南，并指定一名NSICU护士负责病房的感染控制问题。此外，在观察期间出现了几个感染控制问题，并通过引入特定干预策略迅速做出了应对。
定期监测是评估NSICU中医院感染流行病学以及促进开展质量改进活动的宝贵工具。
