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医院感染性败血症:三级新生儿重症监护病房预防措施效果评估

Nosocomial sepsis: evaluation of the efficacy of preventive measures in a level-III neonatal intensive care unit.

作者信息

Almeida Catarina Cardoso de, Pissarra da Silva Susana Maria Saraiva, Flor de Lima Caldas de Oliveira Filipa Silveira Dias, Guimarães Pereira Areias Maria Hercília Ferreira

机构信息

a Faculty of Medicine , Porto University , Porto , Portugal and.

b Neonatal Intensive Care Unit, Centro Hospitalar de São João , Porto , Portugal.

出版信息

J Matern Fetal Neonatal Med. 2017 Sep;30(17):2036-2041. doi: 10.1080/14767058.2016.1236245. Epub 2016 Oct 3.

Abstract

OBJECTIVE

To evaluate nosocomial infections preventive bundle, implemented in April 2010 in Centro Hospitalar de São João (CHSJ) Neonatal Intensive Care Unit (NICU) effectiveness.

METHODS

Newborns admitted to level-III NICU of CHSJ, between 1 April 2007 and 31 March 2013, with sepsis as discharge diagnosis, were selected and divided into two periods (Period 1 and 2, before and after new preventive bundle introduction). Data from the two periods were compared.

RESULTS

Nosocomial sepsis incidence density decreased significantly from 8.6 to 4.8 per 1000 patient days from Period 1 to 2. Nosocomial infections preventive bundle implementation led to a significant decrease in central line-associated bloodstream infections (CLABSI) rates from 14.1 to 10.4 per 1000 catheter days.

CONCLUSIONS

Nosocomial infections preventive bundle implemented revealed efficient in decreasing the incidence density of nosocomial sepsis. However, CLABSI rates remain high. Physicians should be alert to the need to adhere to strict infection control protocols and institute effective measures for nosocomial infection surveillance.

摘要

目的

评估2010年4月在圣若昂中心医院(CHSJ)新生儿重症监护病房(NICU)实施的医院感染预防综合措施的有效性。

方法

选取2007年4月1日至2013年3月31日期间入住CHSJ三级NICU且出院诊断为败血症的新生儿,并分为两个时期(时期1和时期2,即新预防综合措施引入前后)。对两个时期的数据进行比较。

结果

从时期1到时期2,医院败血症的发病密度从每1000患者日8.6例显著降至4.8例。医院感染预防综合措施的实施使中心静脉导管相关血流感染(CLABSI)率从每1000导管日14.1例显著降至10.4例。

结论

实施的医院感染预防综合措施在降低医院败血症的发病密度方面显示出有效性。然而,CLABSI率仍然很高。医生应警惕严格遵守感染控制方案的必要性,并制定有效的医院感染监测措施。

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