Empaire Gabriel D, Guzman Siritt Maria E, Rosenthal Victor D, Pérez Fernando, Ruiz Yvis, Díaz Claudia, Di Silvestre Gabriela, Salinas Evelyn, Orozco Nelva
Hospital de Clínicas Caracas, Caracas, Venezuela.
Hospital Militar "Dr. Carlos Arvelo", Caracas, Venezuela.
Int Health. 2017 Jan;9(1):44-49. doi: 10.1093/inthealth/ihw049.
Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety in the intensive care unit (ICU).
A DA-HAI surveillance study was conducted by the International Nosocomial Infection Control Consortium (INICC) in two adult medical/surgical ICUs at two hospitals in Caracas, Venezuela, in different periods from March 2008 to April 2015, using the US Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC/NHSN) definitions and criteria, and INICC methods.
We followed 1041 ICU patients for 4632 bed days. Central line-associated bloodstream infection (CLABSI) rate was 5.1 per 1000 central line days, ventilator-associated pneumonia (VAP) rate was 7.2 per 1000 mechanical ventilator days, and catheter-associated urinary tract infection (CAUTI) rate was 3.9 per 1000 urinary catheter days, all similar to or lower than INICC rates (4.9 [CLABSI]; 16.5 [VAP]; 5.3 [CAUTI]), and higher than CDC/NHSN rates (0.8 [CLABSI]; 1.1 [VAP]; and 1.3 [CAUTI]). Device utilization ratios were higher than INICC and CDC/NHSN rates, except for urinary catheter, which was similar to INICC. Extra length of stay was 8 days for patients with CLABSI, 9.6 for VAP and 5.7 days for CAUTI. Additional crude mortality was 3.0% for CLABSI, 4.4% for VAP, and 16.9% for CAUTI.
DA-HAI rates in our ICUs are higher than CDC/NSHN's and similar to or lower than INICC international rates.
与设备相关的医疗保健相关感染(DA-HAI)对重症监护病房(ICU)中的患者安全构成威胁。
国际医院感染控制联盟(INICC)于2008年3月至2015年4月的不同时间段,在委内瑞拉加拉加斯的两家医院的两个成人内科/外科ICU中,采用美国疾病控制与预防中心的国家医疗安全网络(CDC/NHSN)的定义和标准以及INICC方法,开展了一项DA-HAI监测研究。
我们对1041例ICU患者进行了4632个床日的随访。中心静脉导管相关血流感染(CLABSI)率为每1000个中心静脉导管日5.1例,呼吸机相关性肺炎(VAP)率为每1000个机械通气日7.2例,导尿管相关尿路感染(CAUTI)率为每1000个导尿管日3.9例,所有这些均与INICC的发生率(4.9 [CLABSI];16.5 [VAP];5.3 [CAUTI])相似或更低,且高于CDC/NHSN的发生率(0.8 [CLABSI];1.1 [VAP];1.3 [CAUTI])。设备使用率高于INICC和CDC/NHSN的发生率,但导尿管除外,其与INICC相似。CLABSI患者的额外住院时间为8天,VAP患者为9.6天,CAUTI患者为5.7天。CLABSI的额外粗死亡率为3.0%,VAP为4.4%,CAUTI为16.9%。
我们ICU中的DA-HAI发生率高于CDC/NSHN的发生率,且与INICC国际发生率相似或更低。