Meric Meliha, Willke Ayşe, Caglayan Cigdem, Toker Kamil
Department of Clinical Microbiology and Infectious Diseases, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Jpn J Infect Dis. 2005 Oct;58(5):297-302.
In this prospective study, 93 intensive care unit (ICU)-acquired infections seen in 131 ICU patients were evaluated. Infection rates were found to be 70.9 in 100 patients and 56.2 in 1,000 patient-days. Pneumonia (35.4%) and bloodstream infections (18.2%) were the most common infections; Staphylococcus aureus (30.9%) and Acinetobacter spp. (26.8%) were the most frequently isolated microorganisms. The results of multivariate logistic regression analyses estimating the risk factors for ICU-acquired infections were as follows: length of stay in ICU (>7 days) (odds ratio [OR]: 7.02; 95% confidence interval [CI]: 2.80-17.56), respiratory failure as a primary cause of admission (OR: 3.7; 95% Cl: 1.41-9.70), sedative medication (OR: 3.34; 95% CI: 1.27-8.79) and operation (before or after admission to ICU) (OR: 2.56; 95% CI: 1.06-6.18). In logistic regression analyses, age (>60 years) (OR: 3.65; 95% CI: 1.48-9.0), APACHE II score >15 (OR: 4.67; 95% CI: 1.92-11.31), intubation (OR: 3.60; 95% CI: 1.05-12.39) and central venous catheterization (OR: 7.85; 95% CI: 1.61-38.32) were found to be significant risk factors for mortality. The difference in mortality rates between patients with ICU-acquired infection and uninfected patients was not statistically significant (mortality rates: 42.3 and 45.6%, respectively). A high incidence of nosocomial infections was found, and the risk factors for ICU-acquired infections and mortality were determined.
在这项前瞻性研究中,对131名重症监护病房(ICU)患者中出现的93例ICU获得性感染进行了评估。发现感染率为每100例患者中有70.9例,每1000个患者日中有56.2例。肺炎(35.4%)和血流感染(18.2%)是最常见的感染类型;金黄色葡萄球菌(30.9%)和不动杆菌属(26.8%)是最常分离出的微生物。多因素逻辑回归分析评估ICU获得性感染危险因素的结果如下:在ICU的住院时间(>7天)(比值比[OR]:7.02;95%置信区间[CI]:2.80 - 17.56)、作为入院主要原因的呼吸衰竭(OR:3.7;95%CI:1.41 - 9.70)、使用镇静药物(OR:3.34;95%CI:1.27 - 8.79)以及(在入住ICU之前或之后的)手术(OR:2.56;95%CI:1.06 - 6.18)。在逻辑回归分析中,年龄(>60岁)(OR:3.65;95%CI:1.48 - 9.0)、急性生理与慢性健康状况评分系统II(APACHE II)评分>15(OR:4.67;95%CI:1.92 - 11.31)、插管(OR:3.60;95%CI:1.05 - 12.39)和中心静脉置管(OR:7.85;95%CI:1.61 - 38.32)被发现是死亡的显著危险因素。ICU获得性感染患者和未感染患者的死亡率差异无统计学意义(死亡率分别为42.3%和45.6%)。发现医院感染发生率较高,并确定了ICU获得性感染和死亡的危险因素。