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2005年芬兰急症医院的医疗保健相关感染:一项全国患病率调查

Healthcare-associated infections in Finnish acute care hospitals: a national prevalence survey, 2005.

作者信息

Lyytikäinen O, Kanerva M, Agthe N, Möttönen T, Ruutu P

机构信息

National Public Health Institute, Helsinki, Finland.

出版信息

J Hosp Infect. 2008 Jul;69(3):288-94. doi: 10.1016/j.jhin.2008.03.005. Epub 2008 Apr 25.

Abstract

The objectives of the first national prevalence survey on healthcare-associated infections (HAIs) in Finland were to assess the extent of HAI, distribution of HAI types, causative organisms, prevalence of predisposing factors and use of antimicrobial agents. The voluntary survey was performed during February-March 2005 in 30 hospitals, including tertiary and secondary care hospitals and 10 (25%) other acute care hospitals in the country. The overall prevalence of HAI was 8.5% (703/8234). Surgical site infection was the most common HAI (29%), followed by urinary tract infection (19%) and primary bloodstream infection or clinical sepsis (17%). HAI prevalence was higher in males, among intensive care and surgical patients, and increased with age and severity of underlying illness. The most common causative organisms, identified in 56% (398/703) of patients with HAIs, were Escherichia coli (13%), Staphylococcus aureus (10%) and Enterococcus faecalis (9%). HAIs caused by multi-resistant microbes were rare (N = 6). A total of 122 patients were treated in contact isolation due to the carriage of multi-resistant microbes. At the time of the survey, 19% of patients had a urinary catheter, 6% central venous line and 1% were ventilated. Antimicrobial treatment was given to 39% of patients. These results can be used for prioritising infection control measures and planning more detailed incidence surveillance of HAI. The survey was a useful tool to increase the awareness of HAI in participating hospitals and to train infection control staff in diagnosing HAIs.

摘要

芬兰首次全国医疗保健相关感染(HAIs)患病率调查的目的是评估HAIs的程度、HAIs类型分布、致病微生物、易感因素患病率以及抗菌药物的使用情况。这项自愿性调查于2005年2月至3月在30家医院进行,包括该国的三级和二级护理医院以及10家(25%)其他急性护理医院。HAIs的总体患病率为8.5%(703/8234)。手术部位感染是最常见的HAIs(29%),其次是尿路感染(19%)和原发性血流感染或临床败血症(17%)。男性、重症监护和手术患者中的HAIs患病率较高,并且随着年龄和基础疾病严重程度的增加而升高。在56%(398/703)的HAIs患者中鉴定出的最常见致病微生物为大肠埃希菌(13%)、金黄色葡萄球菌(10%)和粪肠球菌(9%)。由多重耐药微生物引起的HAIs很少见(N = 6)。共有122名患者因携带多重耐药微生物而接受接触隔离治疗。在调查时,19%的患者有导尿管,6%有中心静脉导管,1%接受机械通气。39%的患者接受了抗菌治疗。这些结果可用于确定感染控制措施的优先次序以及规划更详细的HAIs发病率监测。该调查是提高参与医院对HAIs的认识以及培训感染控制人员诊断HAIs的有用工具。

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