Abdel-Fattah Moataz M
Epidemiololgy and Research Unit, Preventive Medicine Department, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia.
Ger Med Sci. 2005 Sep 1;3:Doc06.
The objectives of the current study are to define how many and what kind of nosocomial infections are occurring, what are the causative microbes and what kind of drugs can be used in treatment of infection at Al-Hada Armed Forces Hospital, Taif, Saudi Arabia during the year 2004. A prospective study was implemented for all cases admitted at Al-Hada Armed Forces Hospital during the period 1(st) January, 2004 till 31(st) December, 2004 and which developed infection. Determination of nosocomial infections was performed using standardized CDC criteria. A total of 1382 patients had developed infection during hospital admission and were included in the study. Of them, 668 (48.3%) had nosocomial infection and 714 (51.7%) had community-acquired infection. Among those who developed nosocomial infections, 216 (32.3%), 172 (25.7%) and 124 (18.6%) had respiratory tract (RTI), urinary tract (UTI) and blood stream infections (BSI) respectively. Surgical site infection (SSI) was reported in 86 cases (12.9%). The overall nosocomial infection rate along the study period was 4.98 per 100 discharged patients. Gram-positive organisms were reported in 31.8%. MRSA (Methicillin-resistant S. aureus) was the commonest (10.2%), followed by coagulase negative staphylococci (8.5%) and MSSA (Methicillin-susceptible S. aureus, 7.4%). While Gram-negative organisms were reported in 66.2%, E. coli was the commonest (22.3%), followed by Pseudomonas aeruginosa (17.6%) and Klebsiella pneumoniae (9.9%). Acinetobacter spp. and MRSA were highly sensitive to Imipenem (88.6%) and Vancomycin (98.5%) respectively. E. coli were highly sensitive to most of the antimicrobial agents except ampicillin (26.6%).
Pneumonia, urinary tract infections, and blood stream infections made up the great majority of nosocomial infections. There is a need for further risk assessment associated with main types of infection.
本研究的目的是确定沙特阿拉伯塔伊夫市哈达武装部队医院在2004年发生了多少例以及何种类型的医院感染,致病微生物是什么,以及可用于治疗感染的药物种类。对2004年1月1日至2004年12月31日期间入住哈达武装部队医院并发生感染的所有病例进行了一项前瞻性研究。医院感染的判定采用标准化的美国疾病控制与预防中心(CDC)标准。共有1382名患者在住院期间发生感染并被纳入研究。其中,668例(48.3%)为医院感染,714例(51.7%)为社区获得性感染。在发生医院感染的患者中,分别有216例(32.3%)、172例(25.7%)和124例(18.6%)发生呼吸道感染(RTI)、尿路感染(UTI)和血流感染(BSI)。86例(12.9%)报告发生手术部位感染(SSI)。研究期间的总体医院感染率为每100例出院患者4.98例。革兰氏阳性菌报告占31.8%。耐甲氧西林金黄色葡萄球菌(MRSA)最为常见(10.2%),其次是凝固酶阴性葡萄球菌(8.5%)和甲氧西林敏感金黄色葡萄球菌(MSSA,7.4%)。而革兰氏阴性菌报告占66.2%,大肠埃希菌最为常见(22.3%),其次是铜绿假单胞菌(17.6%)和肺炎克雷伯菌(9.9%)。不动杆菌属和MRSA分别对亚胺培南(88.6%)和万古霉素(98.5%)高度敏感。大肠埃希菌对大多数抗菌药物高度敏感,但对氨苄西林敏感率为26.6%。
肺炎、尿路感染和血流感染占医院感染的绝大多数。需要对主要感染类型进行进一步的风险评估。