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一项针对 2012 年至 2019 年期间一家三级教学医院重症监护病房中与医疗保健相关的感染的前瞻性监测研究。

A prospective surveillance study of healthcare-associated infections in an intensive care unit from a tertiary care teaching hospital from 2012-2019.

机构信息

Department of Hospital Infection Prevention and Control, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

出版信息

Medicine (Baltimore). 2023 Aug 4;102(31):e34469. doi: 10.1097/MD.0000000000034469.

Abstract

Healthcare-associated infections (HAIs) continue to be the most common adverse event affecting critically ill inpatients in intensive care units (ICUs). Limited data exist in the English literature on the epidemiology of HAIs in ICUs from China. The purpose of this prospective study was to understand the prevalence and trends of HAIs in the ICU to guide clinicians to take effective prevention and control measures. In total, 20 ICU beds in the hospital from January 2012 to December 2019 were selected for surveillance. HAI diagnosis and device-associated infection surveillance were based on the criteria set forth by the original Ministry of Health of the People's Republic of China. The full-time staff for HAI management monitored all patients who stayed in the ICU > 48 hours during the study period and calculated the device utilization ratio and device-associated infection rate. The rate of HAIs and the adjusted rate were 18.78 per 1000 patient-days and 5.17 per 1000 patient-days, respectively. The rates of ventilator-associated pneumonias, catheter-associated urinary tract infections, and central line-associated bloodstream infections were 22.68 per 1000 device-days, 2.40 per 1000 device-days, and 2.27 per 1000 device-days, respectively. A total of 731 pathogenic bacteria were detected in the patients with HAIs. Gram-negative and gram-positive bacteria accounted for 67.44% and 16.83%, respectively. Continuous target monitoring, regular analysis of high-risk factors, and timely intervention measures could effectively reduce HAIs in the ICU. Additionally, these findings could be used for developing new strategies to prevent and control HAIs in ICUs.

摘要

医疗机构相关性感染(HAI)仍然是影响重症监护病房(ICU)中危重病患者的最常见不良事件。关于中国 ICU 中 HAI 的流行病学,英文文献中仅有有限的数据。本前瞻性研究的目的是了解 ICU 中 HAI 的流行情况和趋势,以指导临床医生采取有效的预防和控制措施。总共选择了医院 2012 年 1 月至 2019 年 12 月期间的 20 张 ICU 病床进行监测。HAI 诊断和器械相关感染监测基于原中华人民共和国卫生部制定的标准。HAI 管理的全职工作人员监测研究期间入住 ICU 超过 48 小时的所有患者,并计算了器械使用率和器械相关感染率。HAI 的发生率和调整后的发生率分别为每 1000 患者日 18.78 例和每 1000 患者日 5.17 例。呼吸机相关性肺炎、导管相关性尿路感染和中心静脉导管相关性血流感染的发生率分别为每 1000 器械日 22.68 例、每 1000 器械日 2.40 例和每 1000 器械日 2.27 例。共从 HAI 患者中检出 731 株病原菌。革兰阴性菌和革兰阳性菌分别占 67.44%和 16.83%。连续目标监测、定期分析高危因素和及时干预措施可有效降低 ICU 中的 HAI。此外,这些发现可用于制定新的策略,以预防和控制 ICU 中的 HAI。

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