Kampf G, Wischnewski N, Schulgen G, Schumacher M, Daschner F
Institut für Hygiene, Free Universität Berlin, Nationales Referenzzentrum für Krankenhaushygiene, Germany.
J Clin Epidemiol. 1998 Jun;51(6):495-502. doi: 10.1016/s0895-4356(98)00012-2.
The prevalence and risk factors for nosocomial lower respiratory tract infections (LRTI) in Germany were determined as part of a national survey on nosocomial infections. The study included 14,966 patients in 72 representatively selected hospitals with departments of general medicine, surgery, obstetrics, gynecology, and intensive care units (ICU). Surveillance was carried out by four previously validated medical doctors who strictly applied the CDC-criteria for diagnosis of nosocomial infections. The overall prevalence of hospital-acquired LRTI was 0.72% with the highest rate in hospitals with more than 600 beds (1.08%) and among the patients on intensive care units (9.00%). Ventilator-associated pneumonia rates were highest in patients on ICUs (13.27). Polytrauma, impaired consciousness, chronic airway disease, prior surgery, and cardiovascular disease were significantly related to the occurrence of nosocomial LRTI. P. aeruginosa was the predominant organism causing nosocomial LRTI. Nosocomial LRTI remain a problem mainly on ICUs. Patients at risk should be monitored with extra care.
作为一项关于医院感染的全国性调查的一部分，对德国医院获得性下呼吸道感染（LRTI）的患病率和危险因素进行了测定。该研究纳入了72家具有代表性的医院中的14966名患者，这些医院设有普通内科、外科、妇产科和重症监护病房（ICU）。监测工作由四名先前经过验证的医生进行，他们严格应用美国疾病控制与预防中心（CDC）的医院感染诊断标准。医院获得性LRTI的总体患病率为0.72%，在床位超过600张的医院中患病率最高（1.08%），在重症监护病房的患者中患病率也最高（9.00%）。呼吸机相关性肺炎的发生率在重症监护病房的患者中最高（13.27）。多发伤、意识障碍、慢性气道疾病、既往手术史和心血管疾病与医院获得性LRTI的发生显著相关。铜绿假单胞菌是引起医院获得性LRTI的主要病原体。医院获得性LRTI仍然主要是重症监护病房面临 的一个问题。应对高危患者进行格外仔细的监测。
