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印度尼西亚医院医疗相关感染监测

Surveillance of healthcare-associated infections in Indonesian hospitals.

作者信息

Duerink D O, Roeshadi D, Wahjono H, Lestari E S, Hadi U, Wille J C, De Jong R M, Nagelkerke N J D, Van den Broek P J

机构信息

Department of Infectious Diseases C5-P, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

出版信息

J Hosp Infect. 2006 Feb;62(2):219-29. doi: 10.1016/j.jhin.2005.08.004. Epub 2005 Nov 22.

Abstract

A cross-sectional surveillance of healthcare-associated infections (HAIs) and exposure to risk factors was undertaken in two Indonesian teaching hospitals (Hospitals A and B). Patients from internal medicine, surgery, obstetrics and gynaecology, paediatrics, a class department and intensive care were included. Patient demographics, antibiotic use, culture results, presence of HAI [phlebitis, surgical site infection (SSI), urinary tract infection (UTI) and septicaemia] and risk factors were recorded. To check for interobserver variation, a validation study was performed in Hospital B. In Hospitals A and B, 1,334 and 888 patients were included, respectively. Exposure to invasive devices and surgery was 59%. In Hospital A, 2.8% of all patients had phlebitis, 1.7% had SSI, 0.9% had UTI and 0.8% had septicaemia. In Hospital B, 3.8% had phlebitis, 1.8% had SSI, 1.1% had UTI and 0.8% had septicaemia. In the validation study, the prevalence as recorded by the first team was 2.6% phlebitis, 1.8% SSI, 0.9% UTI and no septicaemia, and that recorded by the second team was 2.2% phlebitis, 2.6% SSI, 3.5% UTI and 0.9% septicaemia. This study is the first to report on HAI in Indonesia. Prevalence rates are comparable to those in other countries. The reliability of the surveillance was insufficient as a considerable difference in prevalence rates was found in the validation study. The surveillance method used is a feasible tool for hospitals in countries with limited healthcare resources to estimate their level of HAI and make improvements in infection control. Efficiency can be improved by restricting the surveillance to include only those patients with invasive procedures. This can help to detect 90% of all infections while screening only 60% of patients.

摘要

在印度尼西亚的两家教学医院(A医院和B医院)开展了一项关于医疗保健相关感染(HAIs)及危险因素暴露情况的横断面监测。纳入了来自内科、外科、妇产科、儿科、一个科室和重症监护室的患者。记录了患者的人口统计学信息、抗生素使用情况、培养结果、HAI的存在情况[静脉炎、手术部位感染(SSI)、尿路感染(UTI)和败血症]以及危险因素。为检查观察者间差异,在B医院进行了一项验证研究。A医院和B医院分别纳入了1334例和888例患者。侵入性器械和手术的暴露率为59%。在A医院,所有患者中2.8%发生静脉炎,1.7%发生SSI,0.9%发生UTI,0.8%发生败血症。在B医院,3.8%发生静脉炎,1.8%发生SSI,1.1%发生UTI,0.8%发生败血症。在验证研究中,第一组记录的患病率为静脉炎2.6%、SSI 1.8%、UTI 0.9%且无败血症,第二组记录的患病率为静脉炎2.2%、SSI 2.6%、UTI 3.5%、败血症0.9%。本研究是首次在印度尼西亚报道HAI情况。患病率与其他国家相当。由于在验证研究中发现患病率存在显著差异,监测的可靠性不足。所采用的监测方法对于医疗资源有限国家的医院来说,是一种估计其HAI水平并改进感染控制的可行工具。通过将监测范围限制在仅接受侵入性操作的患者中可提高效率。这有助于在仅筛查60%的患者时检测出90%的所有感染。

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