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塞尔维亚贝尔格莱德一家三级医院住院手术患者感染的危险因素:一项病例对照研究。

Risk factors for infection in surgical patients hospitalized in a tertiary hospital in Belgrade, Serbia: a case-control study.

作者信息

Šuljagić Vesna, Miljković Ivan, Starčević Srđan, Stepić Nenad, Kostić Zoran, Jovanović Dragutin, Brusić-Renaud Jelena, Mijović Biljana, Šipetić-Grujičić Sandra

机构信息

Department of Nosocomial Infections Control, Military Medical Academy, 11 000 Belgrade, Serbia.

Faculty of Medicine of Military Medical Academy University of Defence, 11000 Belgrade, Serbia.

出版信息

Antimicrob Resist Infect Control. 2017 Mar 27;6:31. doi: 10.1186/s13756-017-0188-x. eCollection 2017.

Abstract

BACKGROUND

The objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital.

METHODS

Risk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI.

RESULTS

The overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems ( = 0.007, OR: 10.62, 95% CI: 1.93-58.4), the admission to intensive care unit ( = 0.004, OR:3.00, 95% CI:1.41-6.40), and the administration of 3rd generation cephalosporins ( = 0.014, OR:2.27, 95% CI:1.18-4.39). Patients with HA CDI had significantly higher in-hospital mortality compared to controls (: 0.007; OR: 8.95; 95% CI: 1.84-43.43).

CONCLUSIONS

CDI is an important HA infection in population of surgical patients and this study emphasizes the importance of the wise use of antibiotics, and other infection control strategies in order to prevent HA CDI, and to decrease the incidence and in-hospital mortality rate.

摘要

背景

本研究的目的是调查外科患者中与医疗保健相关(HA)感染(艰难梭菌感染,CDI)相关的独立危险因素、每个外科病房的感染频率以及单家医院的住院死亡率。

方法

对实验室确诊为HA CDI的外科患者前瞻性评估感染的危险因素,并与无HA CDI的对照组进行比较。

结果

HA CDI的总体发病率为每10000患者日2.6例。HA CDI的显著独立危险因素包括碳青霉烯类药物的使用(P = 0.007,OR:10.62,95%CI:1.93 - 58.4)、入住重症监护病房(P = 0.004,OR:3.00,95%CI:1.41 - 6.40)以及第三代头孢菌素的使用(P = 0.014,OR:2.27,95%CI:1.18 - 4.39)。与对照组相比,HA CDI患者的住院死亡率显著更高(P:0.007;OR:8.95;95%CI:1.84 - 43.43)。

结论

CDI是外科患者群体中一种重要的HA感染,本研究强调了合理使用抗生素及其他感染控制策略对于预防HA CDI、降低发病率和住院死亡率的重要性。

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