Trauma Centre, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
S Afr Med J. 2020 Jan 29;110(2):123-125. doi: 10.7196/SAMJ.2020.v110i2.14243.
Hospital-acquired infections (HAIs) are a major cause of morbidity and mortality. Surgical site infection (SSI) rates are reported to range from 2.5% to 41%. HAI increases the risk of death by 2 - 11%, and three-quarters of these deaths are directly attributable to SSIs.
To determine the incidence of HAI and to identify risk factors amenable to modification with a resultant reduction in infection rates.
An analysis of HAIs was performed between January and April 2018 in the trauma centre surgical wards at Groote Schuur Hospital, Cape Town, South Africa.
There were 769 admissions during the study period. Twenty-two patients (0.03%) developed an HAI. The majority were men, and the mean age was 32 years (range 18 - 57). The mean length of hospital stay (LoS) was 9 days, higher than the mean LoS for the hospital of 6 days. Fourteen patients underwent emergency surgery, 3 patients underwent abbreviated damage control surgery, and 9 patients were admitted to the critical care unit. Most patients with nosocomial sepsis were treated with appropriate culture-based antibiotics (82%). Four patients were treated with amoxicillin/clavulanic acid presumptively prior to culture and sensitivity results, after which antibiotic therapy was tailored. All but 1 patient received antibiotics.
A combination of measures is required to prevent trauma-related infections. By determining the incidence of nosocomial infections in our trauma patients, uniform policies to reduce infection rates further could be determined. Our low incidence of infection may be explained by established preventive care bundles already in place.
医院获得性感染（HAI）是发病率和死亡率的主要原因。据报道，手术部位感染（SSI）的发生率为 2.5%至 41%。HAI 使死亡率增加 2-11%，其中四分之三的死亡直接归因于 SSI。
确定 HAI 的发生率，并确定可通过修改来降低感染率的风险因素。
在南非开普敦格罗特舒尔医院创伤中心外科病房，于 2018 年 1 月至 4 月期间对 HAI 进行了分析。
研究期间有 769 例住院患者。22 名患者（0.03%）发生 HAI。大多数是男性，平均年龄为 32 岁（范围 18-57 岁）。平均住院时间（LoS）为 9 天，高于医院的平均 LOS 6 天。14 名患者接受了急诊手术，3 名患者接受了缩短的损伤控制性手术，9 名患者入住重症监护病房。大多数患有医院获得性脓毒症的患者接受了适当的基于培养的抗生素治疗（82%）。在培养和药敏结果出来之前，有 4 名患者被预防性地使用阿莫西林/克拉维酸进行治疗，之后调整了抗生素治疗方案。除 1 名患者外，所有患者均接受了抗生素治疗。
需要采取综合措施来预防与创伤相关的感染。通过确定我们的创伤患者的医院感染发生率，可以确定进一步降低感染率的统一政策。我们感染发生率低可能是因为已经实施了既定的预防护理措施。
