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加纳医院获得性感染的多中心时点患病率调查。

Multi-centre point-prevalence survey of hospital-acquired infections in Ghana.

机构信息

Department of Microbiology, Korle-Bu Teaching Hospital, Accra, Ghana.

Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.

出版信息

J Hosp Infect. 2019 Jan;101(1):60-68. doi: 10.1016/j.jhin.2018.04.019. Epub 2018 May 3.

Abstract

BACKGROUND

There is a paucity of data describing hospital-acquired infections (HAIs) in Africa.

OBJECTIVE

To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana.

METHODS

Between September and December 2016, point-prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. Medical records of eligible inpatients at or before 8am on the survey date were reviewed to identify HAIs present at the time of the survey.

FINDINGS

Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5% to 14.4%, with higher proportions of infections in secondary and tertiary care facilities. The most common HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%) and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a micro-organism was reported; the most commonly isolated micro-organism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the survey date. The strongest independent predictors for HAI were the presence of an invasive device before onset of infection and duration of hospital stay.

CONCLUSION

A low HAI burden was found compared with findings from other low- and middle-income countries.

摘要

背景

非洲缺乏描述医院获得性感染(HAIs)的数据。

目的

描述加纳急性护理医院中 HAIs 的流行率和分布情况。

方法

2016 年 9 月至 12 月期间,使用欧洲疾病预防控制中心的方案,在参与医院进行了时点患病率调查。在调查日上午 8 点之前,对符合条件的住院患者的病历进行了审查,以确定调查时存在的 HAIs。

结果

对 10 家医院进行了调查,这些医院代表了政府医院所有急性护理床位的 32.9%。在调查的 2107 名住院患者中,有 172 名患者发现了 184 例 HAIs,总患病率为 8.2%。医院的患病率值范围为 3.5%至 14.4%,二级和三级保健机构中感染比例较高。最常见的 HAI 是手术部位感染(32.6%)、血流感染(19.5%)、尿路感染(18.5%)和呼吸道感染(16.3%)。器械相关感染占 HAI 的 7.1%。报告了 12.5%的 HAI 有微生物,最常分离的微生物是大肠杆菌。大约 61%的调查患者正在使用抗生素;调查日有 HAI 的患者中,89.5%至少使用了一种抗菌药物。HAI 的最强独立预测因素是感染前存在侵袭性器械和住院时间。

结论

与其他中低收入国家的发现相比,HAI 的负担较低。

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