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COVID-19大流行期间及之前危重症患者的中心静脉导管相关血流感染

Central Line Associated Bloodstream Infections in Critical Ill Patients during and before the COVID-19 Pandemic.

作者信息

Hlinkova Sona, Moraucikova Eva, Lesnakova Anna, Strzelecka Agnieszka, Littva Vladimir

机构信息

Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia.

Institute of Health Sciences, Collegium Medicum, Kochanowski University, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland.

出版信息

Healthcare (Basel). 2023 Aug 29;11(17):2415. doi: 10.3390/healthcare11172415.

Abstract

(1) Background: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the rates of central line-associated bloodstream infections (CLABSI), its etiology, and risk factors in critically ill patients, because Slovakia was one of the countries experiencing a high burden of COVID-19 infections, and hospitals faced greater challenges in preventing and managing CLABSI; (2) Methods: A retrospective analysis of CLABSI data from all patients admitted to adult respiratory intensive care units before and during COVID-19 pandemic was conducted. We followed the guidelines of the Center for Disease Control surveillance methodology for CLABSI. Data were analyzed using STATISTICA 13.1; (3) Results: We analyzed the data of 803 ICU patients hospitalized for 8385 bed days, with 7803 central line days. Forty-five CLABSI events were identified. The CLABSI rate significantly increased during the COVID-19 pandemic compared to before the COVID-19 pandemic (2.81 versus 7.47 events per 1000 central line days, ( < 0.001). The most frequently identified pathogens causing CLABSI were Gram-negative organisms (60.20%). The risk factors found to increase the probability of developing CLABSI were length of stay (OR = 1.080; 95% Cl: 1.057-1.103; < 0.001) and COVID-19 (OR = 5.485; 95% Cl: 32.706-11.116; < 0.001). (4) Conclusions: The COVID-19 pandemic was associated with increases in CLABSI in ICUs. These data underscore the need to increase efforts in providing surveillance of CLABSI and implementing infection prevention measures.

摘要

(1)背景:本研究旨在评估新冠疫情对重症患者中心静脉导管相关血流感染(CLABSI)发生率、病因及危险因素的影响,因为斯洛伐克是新冠感染负担较重的国家之一,医院在预防和管理CLABSI方面面临更大挑战;(2)方法:对新冠疫情前及疫情期间入住成人呼吸重症监护病房的所有患者的CLABSI数据进行回顾性分析。我们遵循疾病控制中心CLABSI监测方法指南。使用STATISTICA 13.1软件进行数据分析;(3)结果:我们分析了803例ICU患者的数据,这些患者住院8385个床日,中心静脉导管留置天数为7803天。共识别出45例CLABSI事件。与新冠疫情前相比,疫情期间CLABSI发生率显著增加(每1000个中心静脉导管留置日的事件数分别为2.81和7.47,P<0.001)。导致CLABSI最常见的病原体是革兰氏阴性菌(60.20%)。发现增加发生CLABSI可能性的危险因素为住院时间(OR=1.080;95%CI:1.057-1.103;P<0.001)和新冠感染(OR=5.485;95%CI:3.2706-11.116;P<0.001)。(4)结论:新冠疫情与ICU中CLABSI的增加有关。这些数据强调了加强CLABSI监测和实施感染预防措施的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a2/10487552/0cd1e75ecafb/healthcare-11-02415-g001.jpg

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