Inan Dilara, Saba Rabin, Yalcin Ata Nevzat, Yilmaz Murat, Ongut Gozde, Ramazanoglu Atilla, Mamikoglu Latife
Department of Infectious Diseases and Clinical Microbiology, Tip Fakultesi, Infeksiyon Hastaliklari AD, University of Adkeniz, 07050 Antalya, Turkey.
Infect Control Hosp Epidemiol. 2006 Apr;27(4):343-8. doi: 10.1086/503344. Epub 2006 Mar 28.
To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with National Nosocomial Infections Surveillance (NNIS) system rates.
Prospective surveillance study during a period of 27 months. Device utilization ratios and device-associated infection rates were calculated using US Centers for Disease Control and Prevention and NNIS definitions.
Two separate MS ICUs at Akdeniz University Hospital, Antalya, Turkey.
All patients were included who presented with no signs and symptoms of infection within the first 48 hours after admission.
Data on 1,985 patients with a total of 16,892 patient-days were analyzed. The mean overall infection rate per 100 patients was 29.1 infections, and the mean infection rate per 1,000 patient-days was 34.2 infections. The rate of ventilator-associated pneumonia was 20.76 infections per 1,000 ventilator-days, the rate of catheter-associated urinary tract infection was 13.63 infections per 1,000 urinary catheter-days, and the rate of catheter-associated bloodstream infection was 9.69 infections per 1,000 central line-days. The most frequently isolated pathogens were Pseudomonas species among patients with ventilator-associated pneumonias (35.8% of cases), Candida species among patients with catheter-associated urinary tract infections (37.1% of cases), and coagulase-negative staphylococci among patients with catheter-associated bloodstream infections (20.0% of cases).
We found both higher device-associated infection rates and higher device utilization ratios in our MS ICUs than those reported by the NNIS system. To reduce the rate of infection, implementation of infection control practices and comprehensive education are required, and an appropriate nationwide nosocomial infection and control system is needed in Turkey.
描述土耳其一家大学医院内科-外科重症监护病房（MS ICUs）中与设备相关的医院感染发生率，并将其与国家医院感染监测（NNIS）系统的发生率进行比较。
为期27个月的前瞻性监测研究。使用美国疾病控制与预防中心及NNIS的定义计算设备使用率和与设备相关的感染率。
土耳其安塔利亚阿克德尼兹大学医院的两个独立的MS ICUs。
所有在入院后首48小时内无感染体征和症状的患者均纳入研究。
分析了1985例患者共16892个患者日的数据。每100例患者的平均总体感染率为29.1例感染，每1000个患者日的平均感染率为34.2例感染。呼吸机相关性肺炎的发生率为每1000个呼吸机日20.76例感染，导尿管相关性尿路感染的发生率为每1000个导尿管日13.63例感染，中心静脉导管相关性血流感染的发生率为每1000个中心静脉导管日9.69例感染。最常分离出的病原体在呼吸机相关性肺炎患者中为假单胞菌属（占病例的35.8%），在导尿管相关性尿路感染患者中为念珠菌属（占病例的37.1%），在中心静脉导管相关性血流感染患者中为凝固酶阴性葡萄球菌（占病例的20.0%）。
我们发现我们的MS ICUs中与设备相关的感染率和设备使用率均高于NNIS系统报告的水平。为降低感染率，需要实施感染控制措施和进行全面教育，土耳其需要建立一个合适的全国性医院感染及控制系统。
