Orosi Piroska, Farkas Anikó, Berkes Ibolya, Salné Nagy Gyöngyi, Szentkereszty Zoltán, Mályi Katalin, Dán Anikó
Hajdú-Bihar Megyei Onkormányzat Kenézy Gyula Kórház-Rendelointézete, Debrecen.
Orv Hetil. 2007 Aug 5;148(31):1469-73. doi: 10.1556/OH.2007.28010.
According to data in the literature, the number of nosocomial infections in the ICU is far higher than in non-ICU patients. As a result of improving lifesaving technologies, the risk of nosocomial infections increases in ICUs. Utilization of epidemiological methods is recommended for the detection and follow up of nosocomial infections.
Prospective surveillance to assess the epidemiology of nosocomial infections in an ICU.
Kenézy Hospital is a country hospital with 1637 beds and a 16-bed central ICU. During the investigated period (01. 04. 2004-31. 03. 2006) 1490 patients, with a total 8058 ICU days, were hospitalised in the mixed medical-surgical ICU. The commonest primary diagnosis were respiratory failure, multiple trauma and head injury. Surveillance was performed by a trained infection control nurse and was supervised by an infection control physician and infectious disease physician. CDC definitions were used to define nosocomial infections.
A total of 194 nosocomial infections in 134 patients were detected during the study period. The overall incidence and incidence density of nosocomial infections were 13.0 per 100 patients and 24.0 per 1000 patient-days. Respiratory tract infections (44.3%) were the most frequent nosocomial infection, followed by urinary tract (21.1%) and bloodstream infections (20.1%).
Nosocomial surveillance is useful in detecting nosocomial infections in ICU. A multidisciplinary approach and partnership between the physicians and infection control nurses is needed. Patient-to-nurse ratio is an independent risk factor for nosocomial infections in intensive care, this must be kept in mind when planning rationalization of the number of nursing staff.
根据文献数据,重症监护病房(ICU)的医院感染数量远高于非ICU患者。由于救生技术的改进,ICU中医院感染的风险增加。建议采用流行病学方法来检测和跟踪医院感染。
进行前瞻性监测,以评估某ICU中医院感染的流行病学情况。
凯内齐医院是一家拥有1637张床位的乡村医院,设有一个16张床位的中央ICU。在调查期间(2004年4月1日至2006年3月31日),1490名患者在混合内科-外科ICU住院,总计8058个ICU住院日。最常见的主要诊断为呼吸衰竭、多发伤和头部损伤。监测由一名经过培训的感染控制护士进行,并由一名感染控制医生和传染病医生监督。采用美国疾病控制与预防中心(CDC)的定义来界定医院感染。
在研究期间共检测到134例患者发生194例医院感染。医院感染的总体发病率和发病密度分别为每100例患者13.0例和每1000患者日24.0例。呼吸道感染(44.3%)是最常见的医院感染,其次是尿路感染(21.1%)和血流感染(20.1%)。
医院感染监测有助于检测ICU中的医院感染。需要医生和感染控制护士之间采取多学科方法并建立合作关系。患者与护士的比例是重症监护中医院感染的一个独立危险因素,在规划合理的护理人员数量时必须牢记这一点。