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土耳其某神经内科重症监护病房中脑出血和脑梗死患者获得性感染的危险因素。

The risk factors for infections acquired by cerebral hemorrhage and cerebral infarct patients in a neurology intensive care unit in Turkey.

作者信息

Yilmaz Gul Ruhsar, Cevik Mustafa Aydin, Erdinc F Sebnem, Ucler Serap, Tulek Necla

机构信息

Infectious Diseases and Clinical Microbiology Department, Ankara Training and Research Hospital, Ankara, Turkey.

出版信息

Jpn J Infect Dis. 2007 May;60(2-3):87-91.

PMID:17515638
Abstract

Few studies have investigated the risk factors for nosocomial infections developed in neurology intensive care units (ICUs). In this study, the risk factors for ICU-acquired infections in patients with cerebral hemorrhage and cerebral infarct who were treated for more than 24 h at the Ankara Training and Research Hospital were prospectively evaluated over a study period of 14 months. Of 171 patients included in the study, 71 (41.5%) were found to have acquired 163 infections in the ICU unit throughout 1,867 patient days. The rate of infection per 100 patients admitted was 95.3, and per 1,000 patient days, 87.3. The most common nosocomial infections were urinary tract infection (42.9%), pneumonia (27%) and primary bacteremia (19%). Multivariate logistic regression analysis revealed age > or = 70 (P < 0.05), the presence of a central venous catheter (P=0.004), and parenteral nutrition (P=0.02) as ICU-acquired infection risk factors. The presence of infection on admission was identified as a factor decreasing the risk of ICU-acquired infection (P < 0.001). The high infection rates found in this study may be due to lack of full compliance to infection control measures. In conclusion, each type of ICU has its own epidemiological findings for nosocomial infections and thus needs to determine the risk factors using periodical surveillance studies to guide control measures.

摘要

很少有研究调查过神经科重症监护病房(ICU)发生医院感染的危险因素。在本研究中,对在安卡拉培训与研究医院接受治疗超过24小时的脑出血和脑梗死患者发生ICU获得性感染的危险因素进行了为期14个月的前瞻性评估。在纳入研究的171例患者中,发现在1867个患者日期间,有71例(41.5%)在ICU发生了163次感染。每100例入院患者的感染率为95.3,每1000个患者日的感染率为87.3。最常见的医院感染是尿路感染(42.9%)、肺炎(27%)和原发性菌血症(佃%)。多因素逻辑回归分析显示,年龄≥70岁(P<0.05)、存在中心静脉导管(P=0.004)和肠外营养(P=0.02)是ICU获得性感染的危险因素。入院时存在感染被确定为降低ICU获得性感染风险的一个因素(P<0.001)。本研究中发现的高感染率可能是由于未完全遵守感染控制措施所致。总之,每种类型的ICU都有其自身医院感染的流行病学特点,因此需要通过定期监测研究来确定危险因素,以指导控制措施。

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