外科重症监护病房的医院感染：一项回顾性单中心研究。
Nosocomial infections in surgical intensive care unit: A retrospective single-center study.
作者信息
Baviskar Ajit Subhash, Khatib Khalid Ismail, Rajpal Deepali, Dongare Harshad Chandrakant
机构信息
Department of Emergency Medicine, Padmashree Dr. DY Patil Medical College, Navi Mumbai, Maharashtra, India.
Department of Medicine, Smt. Kashibai Navale Medical College, Pune, Maharashtra, India.
出版信息
Int J Crit Illn Inj Sci. 2019 Jan-Mar;9(1):16-20. doi: 10.4103/IJCIIS.IJCIIS_57_18.
AIMS
This study aims to study the incidence, microbiological and antibiotic sensitivity and resistance profile and impact on intensive care units (ICUs) stay and mortality of nosocomial infections in patients admitted to surgical ICU of our hospital.
METHODS
A retrospective analysis of all patients admitted, over the course of 1 year, in the surgical ICU was undertaken. All patients who developed nosocomial infections were included in the study. Incidence, sites, common organisms of nosocomial infection were identified. The antibiotic sensitivity pattern of the microorganisms which were cultured was identified. This group of patients with nosocomial infections was matched with group of patients without nosocomial infections with respect to age, gender, and clinical diagnosis and the impact of nosocomial infections on ICU stay, and mortality was studied.
RESULTS
Of 1051 patients admitted to the ICU during the study, 350 patients developed nosocomial infections and were included in the study group. Of the remaining patients, 350 patients matching the patients in the study group were included in the control group. The prevalence of nosocomial infections in our study was 33.30%. Skin and soft tissue infections (36.30%), including postoperative wound infections were the most common nosocomial infection, followed by respiratory infections (24.46%) and genitourinary infections (23.40%). The most common organisms causing nosocomial infections were (26.59%) and species (18.08%). About 40% of all Gram-negative organisms isolated were multidrug resistant. The average length of stay in ICU was 14.4 days for patients with nosocomial infections and 5.4 days ( < 0.05) for matched patients without nosocomial infections. The mortality in patients with nosocomial infections was 25.14% while that in patients without nosocomial infections was 10.57% ( < 0.05). Overall ICU mortality was 14.27%.
CONCLUSIONS
Nosocomial infections in surgical ICU patients significantly increase ICU length of stay and mortality.
目的
本研究旨在探讨我院外科重症监护病房（ICU）收治患者医院感染的发生率、微生物学特征、抗生素敏感性和耐药情况，以及对ICU住院时间和死亡率的影响。
方法
对1年内收治于外科ICU的所有患者进行回顾性分析。所有发生医院感染的患者均纳入研究。确定医院感染的发生率、感染部位及常见病原体。鉴定培养出的微生物的抗生素敏感性模式。将这组医院感染患者与未发生医院感染的患者按年龄、性别和临床诊断进行匹配，并研究医院感染对ICU住院时间和死亡率的影响。
结果
在研究期间入住ICU的1051例患者中，350例发生医院感染并纳入研究组。其余患者中，350例与研究组患者匹配后纳入对照组。本研究中医院感染的发生率为33.30%。皮肤和软组织感染（36.30%），包括术后伤口感染是最常见的医院感染，其次是呼吸道感染（24.46%）和泌尿生殖系统感染（23.40%）。引起医院感染最常见的病原体是[具体病原体1]（26.59%）和[具体病原体2]种（18.08%）。分离出的所有革兰阴性菌中约40%对多种药物耐药。发生医院感染的患者在ICU的平均住院时间为14.4天，而匹配的未发生医院感染的患者为5.4天（P<0.05）。医院感染患者的死亡率为25.14%，而未发生医院感染的患者死亡率为10.57%（P<0.05）。ICU总体死亡率为14.27%。
结论
外科ICU患者的医院感染显著增加了ICU住院时间和死亡率。
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