Lima Mery Ellen, Andrade Denise de, Haas Vanderlei José
Escola de Enfermagem de Ribeirão Preto, USP.
Departamento de Enfermagem Geral e Especializada, EERP, USP.
Rev Bras Ter Intensiva. 2007 Sep;19(3):342-7.
Care in the intensive care unit (ICU) is constantly challenged by infections related to invasive procedures, which result in increased morbidity and mortality, hospitalization term and costs. This study aimed to prospectively evaluate critical patients according to age, clinical conditions, hospitalization term, occurrence of hospital infection, topography of hospital infection, occurrence of microbial multi-resistance or not, use of invasive procedures and antimicrobial agents.
This is a prospective, observational, clinical research, carried out at an ICU between February and July 2006. The research subjects were critical patients hospitalized for more than 24 hours at the ICU, followed from admission until discharge, transference or death.
The study group consisted of 71 patients with a mean age of 53.5 ± 18.75 years. Forty-seven of these patients (66.2%) acquired hospital infection. Twenty-nine infections (37.6%) occurred in the blood stream, 20 (26%) respiratory and 13 (16.9%) urinary. The most frequent multi-resistant strains were: 14 (10.85%) Pseudomonas aeruginosa, 4 (3.1%) coagulase-negative Staphylococcus sp and 4 (3.1%) Staphylococcus aureus. The most used antimicrobial agents were carbapenem (22.4%), glycopeptides (21.6%) and cephalosporin (21.6%). Twenty-nine (40.8%) of these patients died.
Hospital infection is aggravated if associated to the increased resistance of the microorganisms to the antibiotics.
重症监护病房（ICU）的护理工作一直受到与侵入性操作相关感染的挑战，这些感染会导致发病率和死亡率上升、住院时间延长以及费用增加。本研究旨在根据年龄、临床状况、住院时间、医院感染的发生情况、医院感染的部位、是否存在微生物多重耐药性、侵入性操作的使用情况以及抗菌药物的使用情况，对重症患者进行前瞻性评估。
这是一项于2006年2月至7月在一家ICU进行的前瞻性、观察性临床研究。研究对象为在ICU住院超过24小时的重症患者，从入院直至出院、转院或死亡均进行随访。
研究组由71例患者组成，平均年龄为53.5±18.75岁。其中47例患者（66.2%）发生了医院感染。29例感染（37.6%）发生在血流中，20例（26%）发生在呼吸道，13例（16.9%）发生在泌尿道。最常见的多重耐药菌株为：14株（10.85%）铜绿假单胞菌、4株（3.1%）凝固酶阴性葡萄球菌属和4株（3.1%）金黄色葡萄球菌。最常用的抗菌药物为碳青霉烯类（22.4%）、糖肽类（21.6%）和头孢菌素类（21.6%）。这些患者中有29例（40.8%）死亡。
如果微生物对抗生素的耐药性增加，医院感染会加重。
