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印度东部一家公立三级教学医院重症监护病房的医院感染:发病率、危险因素、转归及相关病原体

Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India.

作者信息

Dasgupta Sugata, Das Soumi, Chawan Neeraj S, Hazra Avijit

机构信息

Department of Anaesthesiology and Critical Care Medicine, R. G. Kar Medical College and Hospital, Kolkata, West Bengal, India.

Department of Medical Research, Breach Candy Hospital, Mumbai, Maharashtra, India.

出版信息

Indian J Crit Care Med. 2015 Jan;19(1):14-20. doi: 10.4103/0972-5229.148633.

Abstract

BACKGROUND

The increased morbidity and mortality associated with nosocomial infections in the intensive care unit (ICU) is a matter of serious concern today.

AIMS

To determine the incidence of nosocomial infections acquired in the ICU, their risk factors, the causative pathogens and the outcome in a tertiary care teaching hospital.

MATERIALS AND METHODS

This was a prospective observational study conducted in a 12 bedded combined medical and surgical ICU of a medical college hospital. The study group comprised 242 patients admitted for more than 48 h in the ICU. Data were collected regarding severity of the illness, primary reason for ICU admission, presence of risk factors, presence of infection, infecting agent, length of ICU and hospital stay, and survival status and logistic regression analysis was done.

RESULTS

The nosocomial infection rate was 11.98% (95% confidence interval 7.89-16.07%). Pneumonia was the most frequently detected infection (62.07%), followed by urinary tract infections and central venous catheter associated bloodstream infections. Prior antimicrobial therapy, urinary catheterization and length of ICU stay were found to be statistically significant risk factors associated with nosocomial infection. Nosocomial infection resulted in a statistically significant increase in length of ICU and hospital stay, but not in mortality.

CONCLUSION

Nosocomial infections increase morbidity of hospitalized patients. These findings can be utilized for planning nosocomial infection surveillance program in our setting.

摘要

背景

重症监护病房(ICU)中医院感染相关的发病率和死亡率增加是当今严重关切的问题。

目的

确定一所三级护理教学医院ICU中医院获得性感染的发生率、危险因素、致病病原体及转归。

材料与方法

这是一项前瞻性观察性研究,在一所医学院校医院拥有12张床位的内科与外科综合ICU中进行。研究组包括242例在ICU住院超过48小时的患者。收集了有关疾病严重程度、入住ICU的主要原因、危险因素的存在情况、感染的存在情况、感染病原体、ICU和住院时间、生存状态的数据,并进行了逻辑回归分析。

结果

医院感染率为11.98%(95%置信区间7.89 - 16.07%)。肺炎是最常检测到的感染(62.07%),其次是尿路感染和中心静脉导管相关血流感染。发现先前的抗菌治疗、导尿和ICU住院时间是与医院感染相关的具有统计学意义的危险因素。医院感染导致ICU和住院时间在统计学上显著延长,但未导致死亡率增加。

结论

医院感染增加了住院患者的发病率。这些发现可用于在我们的环境中规划医院感染监测计划。

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