Lackner F, Wewalka G, Rotter M, Kilian J, Hummel E, Hartenauer U, Gähler R, Scherzer E, Pauser G
Universitätsklinik für Anästhesie und allgemeine Intensivmedizin, Wien, Osterreich.
Anasth Intensivther Notfallmed. 1989 Jun;24(3):133-42.
During a period of 3 months an infection survey was carried out in 4 intensive care units (ICUs), 2 in Vienna, Austria, and one each in Ulm and Münster, Federal Republic of Germany, using a common protocol. A total of 329 patients was monitored prospectively. This pilot study was performed to evaluate the usefulness of parameters included in the monitoring form. It was attempted to characterize the patient populations of the four units. Mean duration of stay (1-12 days), mortality (8-26%), leading diagnosis upon admission, intubation rate (41-91%) and use of pulmonary artery catheter (12-35%) were distinctly different. The rate of patients admitted already with an infection was 9-43%, septicemia was diagnosed in up to 27% of the diseased. The rate of infection acquired in the unit was between 12 and 37%, the most frequent types were bronchopneumonia, septicemia and urinary tract infection. When septicemia patients were compared to non-septicemia patients who had been admitted for more than 3 days, it appeared that the latter stayed significantly shorter at the ICU and showed less frequently bronchopneumonia or urinary tract infection at the time of admission. Septicemia patients acquired more frequently additional infections like broncho-pneumonia or urinary tract infection while staying at the ICU. The median day of onset of septicemia was the fifth day and only in a quarter of cases diagnosis could be supported by a positive blood culture. The use of antibiotics in the 4 ICUs is compared and shows marked differences. Based upon experience with this type of infection survey a new modified protocol is introduced, which displays the time course of documented events.
在3个月的时间里，按照通用方案，对奥地利维也纳的2个重症监护病房（ICU）以及德意志联邦共和国乌尔姆和明斯特各1个ICU进行了感染调查。前瞻性监测了总共329例患者。开展这项初步研究是为了评估监测表中各项参数的实用性。试图对这4个病房的患者群体进行特征描述。平均住院时间（1 - 12天）、死亡率（8 - 26%）、入院时的主要诊断、插管率（41 - 91%）以及肺动脉导管的使用情况（12 - 35%）明显不同。入院时就已感染的患者比例为9 - 43%，多达27%的患病患者被诊断为败血症。在病房获得感染的比例在12%至37%之间，最常见的类型为支气管肺炎、败血症和尿路感染。将败血症患者与入院超过3天的非败血症患者进行比较时发现，后者在ICU的住院时间明显更短，且入院时支气管肺炎或尿路感染的发生率更低。败血症患者在ICU住院期间更频繁地发生如支气管肺炎或尿路感染等额外感染。败血症发病的中位时间为第5天，只有四分之一的病例血培养呈阳性才能支持诊断。对4个ICU中抗生素的使用情况进行了比较，结果显示存在显著差异。基于这类感染调查的经验，引入了一种新的改良方案，该方案展示了记录事件的时间进程。
