Połeć Aleksandra, Wałaszek Marta, Gniadek Agnieszka, Kołpa Małgorzata, Wolak Wiesław
The Department of Nursing in the Institute for Health Care, State Higher Vocational School, Tarnów, Poland
The Department of Nursing Management and Epidemiological Nursing in the Faculty of Health Sciences in Jagiellonian University - Collegium Medicum, Cracow, Poland
Przegl Epidemiol. 2017;71(4):519-529.
Healthcare-Associated Infections (HAI) are the cause of complications in the treatment process. The possibility of infecting a sick person in the Intensive Care Unit (ICU) is many times greater than in other hospital departments
The objective of the study was to investigate the epidemiological indicators and to determine the clinical types of HAI that are present in the ICU during the 5-year period in the St. Lukas District Hospital in Tarnów
HAI has been detected and documented in patients in ICU in the years 2012-2016 by the use of the active monitoring method. We studied patients who spent over 2 days in ICU with a general profile. These studies were conducted in accordance with the methodology recommended by Healthcare-Associated Infections Surveillance Network (HAI-Net) European Center for Disease Prevention and Control (ECDC)
Among 886 patients who were hospitalized for a total of 6711 days, HAI was diagnosed in 195 patients (22.0% incidence rate), the incidence density rate was 29.1 per 1000 person-days of hospitalization. The rate for Ventilator-Associated Pneumonia (VAP) was 12.5 per 1000 ventilator days, for Central Line Associated Bloodstream Infection (CA-BSI) the rate was 8.2 per 1000 central line days, for Catheter-Associated Urinary Tract Infection (CA-UTI) the rate was 3.3 per 1000 urinary catheter days. The average duration of a patient stay in ICU was 24 days (19 days for patients without HAI and 43 days for patients with HAI). The following microorganisms isolated from HAI were prevailing: Acinetobacter baumannii 46 (27%), Staphylococcus aureus 12 (21%), Enterococcus faecalis 17 (10%)
A five-year HAI study in ICU showed that the most common types of infections were bloodstream infections and pneumonia. The incidence rate of VAP remained at similar levels in subsequent years. The CA-BSI rates were reduced over the next three years of the study, but their rise in the last year can prove the lack of stability of the preventive actions. CA-UTI was detected twice less frequently, which can suggest poor detection of this type of infection
医疗保健相关感染（HAI）是治疗过程中并发症的原因。重症监护病房（ICU）中患者被感染的可能性比其他医院科室高出许多倍。
本研究的目的是调查流行病学指标，并确定塔尔努夫圣卢卡斯地区医院ICU在5年期间存在的HAI临床类型。
2012年至2016年期间，通过主动监测方法在ICU患者中检测并记录了HAI。我们研究了在ICU住院超过2天的具有一般特征的患者。这些研究是按照医疗保健相关感染监测网络（HAI-Net）欧洲疾病预防控制中心（ECDC）推荐的方法进行的。
在总共住院6711天的886名患者中，195名患者被诊断为HAI（发病率为22.0%），发病密度率为每1000人住院日29.1例。呼吸机相关性肺炎（VAP）的发生率为每1000个呼吸机日12.5例，中心静脉导管相关血流感染（CA-BSI）的发生率为每1000个中心静脉导管日8.2例，导尿管相关尿路感染（CA-UTI）的发生率为每1000个导尿管日3.3例。患者在ICU的平均住院时间为24天（无HAI的患者为19天，有HAI的患者为43天）。从HAI中分离出的以下微生物占主导地位：鲍曼不动杆菌46株（27%），金黄色葡萄球菌12株（21%），粪肠球菌17株（10%）。
对ICU进行的为期五年的HAI研究表明，最常见的感染类型是血流感染和肺炎。VAP的发病率在随后几年保持在相似水平。在研究的接下来三年中，CA-BSI的发生率有所降低，但在最后一年有所上升，这可能证明预防措施缺乏稳定性。CA-UTI的检测频率低两倍，这可能表明对这类感染的检测不足
