波兰重症监护感染流行率（PPIC）：一项为期一天的时点患病率多中心研究。

The Polish Prevalence of Infection in Intensive Care (PPIC): A one-day point prevalence multicenter study.

机构信息

Department of Anesthesiology and Intensive Therapy, Military Institute of Medicine, Warszawa, Poland.

Department of Anesthesiology and Intensive Care, Wrocław University Hospital, Poland.

出版信息

Adv Clin Exp Med. 2019 Jul;28(7):907-912. doi: 10.17219/acem/94147.

DOI:10.17219/acem/94147

PMID:30986000

Abstract

BACKGROUND

Infections in critically ill patients are the main reasons for a lack of therapeutic success and increased mortality in intensive care units (ICUs). There have been many analyses of the incidence of infections in ICUs; however, no large studies of this kind have been conducted either in Poland or in Eastern and Central Europe.

OBJECTIVES

The aim of the research was to undertake a one-day study of the prevalence of infections in ICUs in Warszawa and the Mazovian region of Poland.

MATERIAL AND METHODS

A prospective questionnaire survey analysis - a one-day prevalence study of infections - was carried out on June 25, 2014, in 28 ICUs in Poland.

RESULTS

Among 205 ICU patients (193 adults and 12 children), 134 infections were found in 101 patients (99/193 adults (51.30%) and 2/12 children (16.70%)), and bacterial colonization in 19/205 (9.3%) patients. In 66.42% of the cases, more than 1 site of infection was diagnosed. On the day of the study, 75.40% of the diagnosed infections had positive microbiological results. The most frequent were respiratory tract infections (53.73%), wound infections (18.65%) and bloodstream infections (14.92%). Most of the infections (64.10%) were caused by Gram-negative bacteria (GN), followed by Gram-positive bacteria (GP; 31.80%) and fungi (4.10%). The most frequently reported GN microorganisms were Enterobacteriaceae (44.7%). Methicillin-resistant Staphylococcus aureus (MRSA) infections were found in 8.80% of the patients. Antibiotics were administered to 75.60% of the adult patients, in 69.20% as targeted treatment. Mechanical ventilation, central vein catheterization and urinary bladder catheterization were used in 67.80%, 85.85% and 94.63% of the patients, respectively.

CONCLUSIONS

On the day of the study, more than half of the patients had infections, mostly from GN bacteria. Respiratory tract infections were the main type found. In about 2/3 of the patients, antibiotics were administered, mainly as targeted therapy.

摘要

背景

在重症监护病房（ICU）中，感染是治疗失败和死亡率增加的主要原因。已经有许多关于 ICU 感染发生率的分析，但在波兰或东欧和中欧，都没有进行过此类大型研究。

目的

本研究旨在对波兰华沙及其马佐夫舍地区 ICU 中的感染进行为期一天的患病率研究。

材料与方法

2014 年 6 月 25 日，对波兰 28 家 ICU 进行了前瞻性问卷调查分析——为期一天的感染患病率研究。

结果

在 205 名 ICU 患者（193 名成人和 12 名儿童）中，101 名患者（99/193 名成人（51.30%）和 2/12 名儿童（16.70%））发现了 134 例感染，205 名患者中有 19 名（9.3%）存在细菌定植。在 66.42%的情况下，诊断出一个以上部位的感染。在研究当天，75.40%诊断出的感染具有阳性微生物学结果。最常见的是呼吸道感染（53.73%）、伤口感染（18.65%）和血流感染（14.92%）。大多数感染（64.10%）由革兰氏阴性菌（GN）引起，其次是革兰氏阳性菌（GP；31.80%）和真菌（4.10%）。报告的 GN 微生物中最常见的是肠杆菌科（44.7%）。耐甲氧西林金黄色葡萄球菌（MRSA）感染见于 8.80%的患者。75.60%的成年患者使用了抗生素，69.20%作为靶向治疗。机械通气、中心静脉导管和膀胱导管分别在 67.80%、85.85%和 94.63%的患者中使用。