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烧伤重症监护病房的医院感染特征:一项为期十一年的主动监测分析

Nosocomial infection characteristics in a burn intensive care unit: analysis of an eleven-year active surveillance.

作者信息

Öncül Oral, Öksüz Sinan, Acar Ali, Ülkür Ersin, Turhan Vedat, Uygur Fatih, Ulçay Asım, Erdem Hakan, Özyurt Mustafa, Görenek Levent

机构信息

Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Infectious Disease and Clinical Microbiology, Istanbul, Turkey.

Gulhane Military Medical Academy, Haydarpasa Training Hospital, Department of Plastic Reconstructive and Aesthetic Surgery, Burn Unit, Istanbul, Turkey.

出版信息

Burns. 2014 Aug;40(5):835-41. doi: 10.1016/j.burns.2013.11.003. Epub 2013 Dec 2.

Abstract

AIMS

The objective of this study was to describe nosocomial infection (NI) rates, risk factors, etiologic agents, antibiotic susceptibility, invasive device utilization and invasive device associated infection rates in a burn intensive care unit (ICU) in Turkey.

METHODS

Prospective surveillance of nosocomial infections was performed according to Centers for Disease Control and Prevention (CDC) and National Healthcare Safety Network (NHSN) criteria between 2001 and 2012. The data was analyzed retrospectively.

RESULTS

During the study period 658 burn patients were admitted to our burn ICU. 469 cases acquired 602 NI for an overall NI rate of 23.1 per 1000 patient days. 109 of all the cases (16.5%) died. Pseudomonas aeruginosa (241), Acinetobacter baumannii (186) and Staphylococcus aureus (69) were the most common identified bacteria in 547 strains.

CONCLUSION

Total burn surface area, full thickness burn, older age, presence of inhalation injury were determined to be the significant risk factors for acquisition of NI. Determining the NI profile at a certain burn ICU can lead the medical staff apply the appropriate treatment regimen and limit the drug resistance. Eleven years surveillance report presented here provides a recent data about the risk factors of NI in a Turkish burn ICU.

摘要

目的

本研究的目的是描述土耳其一家烧伤重症监护病房(ICU)的医院感染(NI)发生率、危险因素、病原体、抗生素敏感性、侵入性设备使用情况以及与侵入性设备相关的感染率。

方法

根据疾病控制与预防中心(CDC)和国家医疗安全网络(NHSN)的标准,于2001年至2012年对医院感染进行前瞻性监测。对数据进行回顾性分析。

结果

在研究期间,658例烧伤患者入住我们的烧伤ICU。469例患者发生了602次医院感染,总体医院感染率为每1000个患者日23.1次。所有病例中有109例(16.5%)死亡。在547株菌株中,铜绿假单胞菌(241株)、鲍曼不动杆菌(186株)和金黄色葡萄球菌(69株)是最常见的已鉴定细菌。

结论

烧伤总面积、深度烧伤、年龄较大、存在吸入性损伤被确定为发生医院感染的重要危险因素。确定某一烧伤ICU的医院感染情况可使医务人员应用适当的治疗方案并限制耐药性。此处呈现的11年监测报告提供了关于土耳其一家烧伤ICU医院感染危险因素的最新数据。

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