Department of Urology and School of Medicine, Universidad Complutense Madrid, Hospital Universitario 12 de Octubre, Avda. Córdoba s/n, 28041, Madrid, Spain.
Department of Infectious Diseases, School of Medicine, Universidad Complutense de Madrid and Health Research Institute i + 12, Hospital Universitario 12 de Octubre, Madrid, Spain.
World J Urol. 2020 Jan;38(1):3-8. doi: 10.1007/s00345-019-02648-3. Epub 2019 Jan 30.
Our purpose is to present the results of our working group, with a view to reduce the incidence and improve the management of healthcare-associated infections (HAIs) in a urology ward.
The study consists on an observational database designed with the view to analyse the incidence and characteristics of HAIs in Urology. Based on the results obtained, a critical evaluation was carried out and specific measures put in place to reduce HAIs. Finally, the impact and results of the implemented measures were periodically evaluated.
The incidence of HAIs in urology decreased from 6.6 to 7.3% in 2012-2014 to 5.4-5.8% in 2016-2018. In patients with immunosuppression the incidence of HAIs decreased from 12.8 to 18% in 2012-2013 to 8.1-10.2% in 2017-2018, in those with a previous urinary infection fell from 13.6 to 4.8%, in those with a urinary catheter prior to admission from 12.6 to 10.8%, and in patients with a nephrostomy tube from 16 to 10.9%. The effect of the protocol also demonstrated a reduction in the percentage of patients with suspicion of HAIs for whom no culture was taken, from 6% in 2012 to zero in 2017 and 2018. Moreover, the implementation of protocols for empirical treatment has reduced the incidence of patients experiencing inadequate empirical antimicrobial therapy from 20 to 8.1%.
It is essential to monitor the incidence of HAIs, and preventive measures play a useful role in reducing the rate of infection and in optimising their management.
本研究旨在展示工作组的研究结果，以期降低泌尿外科病房中医疗相关性感染（HAI）的发生率并改善其管理。
本研究设计了一个观察性数据库，旨在分析泌尿外科中 HAI 的发生率和特征。基于所得结果，进行了批判性评估，并采取了具体措施来降低 HAI 的发生率。最后，定期评估所实施措施的影响和结果。
泌尿外科 HAI 的发生率从 2012-2014 年的 6.6%-7.3%降至 2016-2018 年的 5.4%-5.8%。在免疫抑制患者中，HAI 的发生率从 2012-2013 年的 12.8%-18%降至 2017-2018 年的 8.1%-10.2%，在先前存在尿路感染的患者中从 13.6%-4.8%，在入院前存在导尿管的患者中从 12.6%-10.8%，在存在肾造口管的患者中从 16%-10.9%。该方案的实施还证明，疑似 HAI 但未进行培养的患者比例从 2012 年的 6%降至 2017 年和 2018 年的 0%。此外，实施经验性治疗方案降低了接受不适当经验性抗菌治疗的患者比例，从 20%降至 8.1%。
监测 HAI 的发生率至关重要，预防措施在降低感染率和优化管理方面发挥了有益作用。
