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三级护理重症监护病房中心静脉导管相关血流感染的监测与结果

Monitoring and Outcomes of Central Line-Associated Bloodstream Infections in a Tertiary Care Intensive Care Unit.

作者信息

Kharduit Peter B, Dutta Kaustuv, Lyngdoh Clarissa J, Bhattacharyya Prithwis, Lyngdoh Valarie, Khyriem Annie B, Devi Suriya K

机构信息

Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.

Anesthesiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, IND.

出版信息

Cureus. 2024 Jun 28;16(6):e63428. doi: 10.7759/cureus.63428. eCollection 2024 Jun.

Abstract

Background Central line-associated bloodstream infections (CLABSIs) are significant healthcare-associated infections that increase morbidity, mortality, and healthcare costs. This study aims to analyze the frequency, microbiology, risk factors, and outcomes of CLABSI in an adult intensive care unit. Methods We conducted a hospital-based, prospective surveillance study in the critical care unit of a tertiary care hospital. We included patients with a central line (CL) from admission until discharge or line removal. Data collection focused on patient demographics, comorbidities, CL insertion site, and CLABSI rates. The incidence of CLABSI was calculated per 1,000 CL-days, and statistical analysis was performed using the Chi-square test. Results Of the 169 patients enrolled, 123 episodes of bloodstream infections were recorded, 56 (45.5%) of which were CLABSIs. The organisms most frequently isolated were (n = 14; 24.6%), (n = 11; 19.3%), species (n = 7; 12.28%), and (n = 7; 12.28%). The overall CLABSI rate was 24.70 per 1,000 CL-days. No significant association was found between CLABSI and patient age, gender, or the site of CL insertion. However, a significant relationship was observed between CLABSI and the presence of comorbid conditions (p = 0.001). The study also noted a high rate of antibiotic resistance among the isolated pathogens. Conclusions Our results emphasize the need for stringent infection control measures and suggest that comorbid conditions significantly increase the risk of CLABSI. Addressing antibiotic resistance and implementing effective prevention strategies are essential for reducing the burden of CLABSIs.

摘要

背景

中心静脉导管相关血流感染(CLABSIs)是严重的医疗相关感染,会增加发病率、死亡率和医疗成本。本研究旨在分析成人重症监护病房中CLABSI的发生频率、微生物学、危险因素及结局。方法:我们在一家三级医院的重症监护病房开展了一项基于医院的前瞻性监测研究。纳入从入院至出院或拔除导管期间留置中心静脉导管(CL)的患者。数据收集集中于患者人口统计学信息、合并症、CL置入部位及CLABSI发生率。CLABSI发病率按每1000个CL日计算,并采用卡方检验进行统计分析。结果:在纳入的169例患者中,记录到123例血流感染事件,其中56例(45.5%)为CLABSIs。最常分离出的病原体为[具体病原体1](n = 14;24.6%)、[具体病原体2](n = 11;19.3%)、[具体病原体3]种(n = 7;12.28%)和[具体病原体4](n = 7;12.28%)。CLABSI总体发生率为每1000个CL日24.70例。未发现CLABSI与患者年龄、性别或CL置入部位之间存在显著关联。然而,观察到CLABSI与合并症的存在之间存在显著关系(p = 0.001)。该研究还指出分离出的病原体中抗生素耐药率很高。结论:我们的结果强调了严格感染控制措施的必要性,并表明合并症会显著增加CLABSI的风险。应对抗生素耐药性并实施有效的预防策略对于减轻CLABSIs的负担至关重要。

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