Valero Juan L F, Campos R M, Sáenz González M C
Hospital Universitario, Facultad de Medicina, Salamanca.
Rev Clin Esp. 1996 May;196(5):281-8.
Patients admitted to the Intensive Care Unit (ICU) have a 5-10-fold higher risk for developing nosocomial infection (NI) than in other hospital wards. The constant evolution of epidemiological characteristics of NI in these departments, as well as the growing susceptibility of patients make it necessary to carry out a continuous epidemiological surveillance of these conditions. The aim of this work was, therefore, to know the incidence of nosocomial infection in ICUs, their epidemiological characteristics and the use of antimicrobial agents in infected patients obtained through the information provided by the active surveillance system carried out at Hospital Clínico Universitario, Salamanca, for the 1993-1994 period. The incidence of infected patients and infections were 21.7% and 47.6%, respectively; the mean age of infected patients was 61 +/- 9.6 years and 29.6% of patients died. Sixty-four percent of infections corresponded to pneumonia and bacteremia, with incidences of 15.5% and 14.9%, respectively. The main responsible agents for pneumonia, bacteremia, surgical wound infection, urinary tract infection were P. aeruginosa, S. epidermidis, Enterococcus sp., and Candida sp., respectively. All infected patients had a central catheter in place an 57.7% were under mechanical ventilation. The most commonly used antimicrobial agents were amikacin, ceftazidime, cefotaxime, vancomycin, metronidazole, and gentamicin.
入住重症监护病房（ICU）的患者发生医院感染（NI）的风险比其他医院病房高5至10倍。这些科室中NI的流行病学特征不断演变，以及患者易感性的增加使得有必要对这些情况进行持续的流行病学监测。因此，这项工作的目的是通过萨拉曼卡大学临床医院在1993 - 1994年期间开展的主动监测系统所提供的信息，了解ICU中医院感染的发生率、其流行病学特征以及感染患者中抗菌药物的使用情况。感染患者和感染的发生率分别为21.7%和47.6%；感染患者的平均年龄为61±9.6岁，29.6%的患者死亡。64%的感染为肺炎和菌血症，发生率分别为15.5%和14.9%。肺炎、菌血症、手术伤口感染、尿路感染的主要病原体分别为铜绿假单胞菌、表皮葡萄球菌、肠球菌属和念珠菌属。所有感染患者均有中心静脉导管，57.7%的患者接受机械通气。最常用的抗菌药物是阿米卡星、头孢他啶、头孢噻肟、万古霉素、甲硝唑和庆大霉素。
