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Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: findings of the International Nosocomial Infection Control Consortium.上海某医院采用多维方法对呼吸机相关性肺炎发生率的影响:国际医院感染控制联盟的研究结果。
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Device-associated infection rates in 398 intensive care units in Shanghai, China: International Nosocomial Infection Control Consortium (INICC) findings.中国上海 398 家重症监护病房器械相关感染率:国际医院感染控制联盟(INICC)研究结果。
Int J Infect Dis. 2011 Nov;15(11):e774-80. doi: 10.1016/j.ijid.2011.06.009. Epub 2011 Aug 16.
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Is there an association between nosocomial infection rates and bacterial cross transmissions?医院感染率与细菌交叉传播之间是否存在关联?
Crit Care Med. 2010 Jan;38(1):46-50. doi: 10.1097/CCM.0b013e3181b42a9b.
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Surveillance of hospital-acquired infections based on electronic hospital registries.基于电子医院登记系统的医院获得性感染监测。
J Hosp Infect. 2006 Jan;62(1):71-9. doi: 10.1016/j.jhin.2005.04.002. Epub 2005 Aug 15.
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Nosocomial infections in intensive care unit in a Turkish university hospital: a 2-year survey.土耳其一所大学医院重症监护病房的医院感染:一项为期两年的调查。
Intensive Care Med. 2003 Sep;29(9):1482-8. doi: 10.1007/s00134-003-1788-x. Epub 2003 Aug 1.
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Severity-of-illness markers as predictors of nosocomial infection in adult intensive care unit patients.疾病严重程度标志物作为成人重症监护病房患者医院感染的预测指标
Am J Infect Control. 2002 May;30(3):139-44. doi: 10.1067/mic.2002.121662.
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Infection control in the ICU.重症监护病房的感染控制
Chest. 2001 Dec;120(6):2059-93. doi: 10.1378/chest.120.6.2059.
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Risk factors for nosocomial intensive care infection: a long-term prospective analysis.医院重症监护病房感染的危险因素:一项长期前瞻性分析。
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Risk factors for early-onset, ventilator-associated pneumonia in critical care patients: selected multiresistant versus nonresistant bacteria.重症监护患者早发性呼吸机相关性肺炎的危险因素:特定多重耐药菌与非耐药菌的比较
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重组麻醉重症监护病房感染率变化的调查:一项回顾性研究。

Examination of Changes in Infection Rates in a Restructured Anaesthesia Intensive Care Unit: A Retrospective Study.

作者信息

Deniz Ahmet, Erhan Ömer Lütfi, Bayar Mustafa Kemal, Karatepe Ümit, Demirel İsmail

机构信息

Department of Anaesthesiology and Reanimation, Fırat University School of Medicine, Elazığ, Turkey.

Department of Anaesthesiology and Reanimation, Ankara University School of Medicine, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2017 Dec;45(6):353-360. doi: 10.5152/TJAR.2017.68095. Epub 2017 Nov 29.

DOI:10.5152/TJAR.2017.68095
PMID:29359075
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5772415/
Abstract

OBJECTIVE

This retrospective study aimed to evaluate the effect of a restructured anaesthesia intensive care unit (ICU) on changes in infection rates and infections.

METHODS

Organisational restructuring was done in the anaesthesia ICU of Firat University Hospital after it was relocated on 14 March 2012. This study was designed to investigate the effect of restructuring on infection rates through a comparison of periods encompassing one year before relocation and one year after relocation. Nosocomial infections were diagnosed according to modified Centers for Disease Control and Prevention (CDC) criteria. In total, 406 patients who were over 18 years old and admitted to the ICU were included; they were hospitalised for 48 h or longer and had non-infectious diseases according to physical examination, laboratory and culture results on admission. The data of 214 patients (Group A) and 192 patients (Group B) were examined.

RESULTS

Parameters such as age, gender, primary diagnosis and mean GCS score at admission and mean duration of hospitalisation showed no effect on the rates of infection, but rates of total infection (41.1% vs. 25%), urinary (18.7% vs. 10.4%) and VIP (32.7% vs. 14.6%) were detected in Groups A and B. Statistically significant differences were found for the causative pathogens Pseudomonas (15.4% vs. 6.8%), Acinetobacter (18.2% vs. 12%) and Escherichia (8.9% vs. 2.1%); the mean duration of mechanical ventilation (15.01±16.681 vs. 12.22±17.595) and discharge with improvement (31.8% vs. 44.3%).

CONCLUSION

We detected that restructuring (such as acclimatization, educated staff, hepa filter) caused a significant decline in infection rates. Because ICU staff may be a major cause of infection, we believe that providing education and conducting effective surveillance programs will be the most important factors for reducing infection rates.

摘要

目的

本回顾性研究旨在评估重组后的麻醉重症监护病房(ICU)对感染率变化及感染情况的影响。

方法

菲拉特大学医院麻醉ICU于2012年3月14日搬迁后进行了组织架构重组。本研究旨在通过比较搬迁前一年和搬迁后一年的时间段来调查重组对感染率的影响。医院感染根据美国疾病控制与预防中心(CDC)修改后的标准进行诊断。总共纳入了406例18岁以上入住ICU的患者;他们住院时间为48小时或更长时间,根据入院时的体格检查、实验室检查和培养结果患有非感染性疾病。对214例患者(A组)和192例患者(B组)的数据进行了检查。

结果

年龄、性别、入院时的主要诊断、平均格拉斯哥昏迷评分(GCS)以及平均住院时间等参数对感染率无影响,但A组和B组的总感染率(41.1%对25%)、泌尿系统感染率(18.7%对10.4%)和血管内导管相关感染率(32.7%对14.6%)有所不同。在致病病原体方面发现了统计学上的显著差异,如铜绿假单胞菌(15.4%对6.8%)、不动杆菌(18.2%对12%)和大肠埃希菌(8.9%对2.1%);机械通气的平均持续时间(15.01±16.681对12.22±17.595)以及好转出院率(31.8%对4)。

结论

我们发现重组(如环境适应、工作人员培训、高效空气过滤器)导致感染率显著下降。由于ICU工作人员可能是感染的主要原因,我们认为提供培训和开展有效的监测计划将是降低感染率的最重要因素。