Duszyńska Wiesława, Barteczko Barbara, Kübler Andrzej
Klinika Anestezjologii i Intensywnej Terapii AM we Wrocławiu.
Anestezjol Intens Ter. 2008 Jan-Mar;40(1):17-21.
The Hospitals in Europe Link for Infection Control through Surveillance (HELICS) network has been implemented in 15 countries of the EU. The network has been responsible for standardization of definitions, collection of data, and therapeutic procedures. The aim of study was to assess the usefulness of ICU-HELICS programme for surveillance of infections in ITU.
The following data were recorded: kind of infections and their incidence, device utilization ratios for lung ventilation, central venous and urinary catheters. Infections were diagnosed according to CDC and HELICS criteria.
During the 12-months period nosocomial infection was diagnosed in 62 out of 178 patients (35%). The incidence of device-associated nosocomial infection was 34.8 per 1000 patients, and the incidence of ventilator-associated pneumonia (VAP) was 16 per 1000 ventilator days. CVC-related bloodstream infections (BSI) occurred in 5.6 cases per 1000 catheter days. The incidence of catheter-associated urinary tract infections (UTI) was 6.8 per 1000 catheterisation days. The most common pathogen in VAP was Acinetobacter baumanii and in UTI--methicillin-resistant coagulase-negative Staphylococci.
In the present study overall incidence of nosocomial infections within ITU was not found to be different from that in 1995. The incidence of device-associated nosocomial infections was higher than the mean value for developing countries, but lower than in Finland. The incidence of VAP was higher than in USA and in the majority of European countries with the exception of Holland, Spain, and Finland. In conclusion, we found the HELICS networkto be very helpful, allowing for observation and analysis of nosocomial infections and comparison with other centres.
欧洲医院感染控制监测网络(HELICS)已在欧盟15个国家实施。该网络负责定义的标准化、数据收集和治疗程序。本研究的目的是评估ICU-HELICS计划在重症监护病房感染监测中的实用性。
记录以下数据:感染类型及其发生率、肺通气、中心静脉和导尿管的设备使用率。根据美国疾病控制与预防中心(CDC)和HELICS标准诊断感染。
在12个月期间,178例患者中有62例(35%)被诊断为医院感染。器械相关医院感染的发生率为每1000例患者34.8例,呼吸机相关性肺炎(VAP)的发生率为每1000呼吸机日16例。中心静脉导管相关血流感染(BSI)每1000导管日发生5.6例。导尿管相关尿路感染(UTI)的发生率为每1000导尿日6.8例。VAP中最常见的病原体是鲍曼不动杆菌,UTI中是耐甲氧西林凝固酶阴性葡萄球菌。
在本研究中,重症监护病房内医院感染的总体发生率与1995年相比没有差异。器械相关医院感染的发生率高于发展中国家的平均值,但低于芬兰。VAP的发生率高于美国以及除荷兰、西班牙和芬兰之外的大多数欧洲国家。总之,我们发现HELICS网络非常有用,能够对医院感染进行观察和分析,并与其他中心进行比较。