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评价危重症患者医院感染及其危险因素。

Evaluation of nosocomial infections and risk factors in critically ill patients.

机构信息

Department of Medical Microbiology, School of Medicine, Mustafa Kemal University, Hatay, Turkey.

出版信息

Med Sci Monit. 2011 Feb 25;17(3):PH17-22. doi: 10.12659/msm.881434.

Abstract

BACKGROUND

Nosocomial infections are one of the most serious complications in intensive care unit patients because they lead to high morbidity, mortality, length of stay and cost. The aim of this study was to determine the nosocomial infections, risk factors, pathogens and the antimicrobial susceptibilities of them in intensive care unit of a university hospital.

MATERIAL/METHODS: The patients were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory.

RESULTS

20.1% of the patients developed a total of 40 intensive care unit-acquired infections for a total of 988 patient-days. The infection sites were the lower respiratory tract, urinary tract, bloodstream, wound, and the central nervous system. The respiratory deficiency, diabetes mellitus, usage of steroid and antibiotics were found as the risk factors. The most common pathogens were Enterobacteriaceae, Staphylococcus aureus, Candida species. No vancomycin resistance was determined in Gram positive bacteria. Imipenem and meropenem were found to be the most effective antibiotics to Enterobacteriaceae.

CONCLUSIONS

Hospital infection rate in intensive care unit is not very high. The diabetes mellitus, length of stay, usage of steroids, urinary catheter and central venous catheter were determined as the risk factors by the final logistic regression analysis. These data, which were collected from a newly established intensive care unit of a university hospital, are important in order to predict the infections and the antimicrobial resistance profile that will develop in the future.

摘要

背景

医院感染是重症监护病房患者最严重的并发症之一,因为它们会导致高发病率、死亡率、住院时间和费用。本研究的目的是确定一所大学医院重症监护病房的医院感染、危险因素、病原体及其抗菌药物敏感性。

材料/方法:采用基于患者和实验室的单位定向主动监测方法对患者进行前瞻性观察。

结果

共有 40 名患者发生了总计 988 人日的重症监护病房获得性感染,感染率为 20.1%。感染部位为下呼吸道、泌尿道、血流、伤口和中枢神经系统。呼吸衰竭、糖尿病、类固醇和抗生素的使用被认为是危险因素。最常见的病原体是肠杆菌科、金黄色葡萄球菌、念珠菌属。革兰氏阳性菌中未发现万古霉素耐药。亚胺培南和美罗培南被发现对肠杆菌科最有效。

结论

重症监护病房的医院感染率不是很高。最终的逻辑回归分析确定了糖尿病、住院时间、类固醇使用、导尿管和中心静脉导管是危险因素。这些数据是从一所新成立的大学医院重症监护病房收集的,对于预测未来可能发生的感染和抗菌药物耐药谱非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b84b/3524731/267651103bcf/medscimonit-17-3-PH17-g001.jpg

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