重症监护病房医疗保健相关感染的评估

Barış BALASAR, Mustafa Çağrı ERGÜN, Betül ERGÜN, Esma EROĞLU
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摘要

目的:本研究旨在评估我院2年来医疗保健相关感染(HAIs)的现状,与病原体及其分布、有创机械通气的使用和持续时间、感染率和发病率的关系,并与全国数据进行比较。方法:选取2019年1月1日至2020年12月31日在Meram州立医院内科icu收治的患者。在2年期间,根据美国疾病控制与预防中心(CDC)和国家医院感染监测网络(NNISN)的标准,共有47名患者被诊断为HAIs。结果:922例ICU住院患者6041 d随访,共检出HAIs 47例。最常见的HAIs类型包括21例(45.6%)卫生保健相关肺炎和12例(26.1%)其他呼吸系统感染。最常见的病原体为鲍曼不动杆菌(Acinetobacter baumannii), 27例(50.9%)。结论:由于有创器械使用频繁、住院时间延长、并发症增多等因素,HAIs是icu不可避免的情况。卫生保健机构的主要卫生目标之一是控制和管理卫生保健机构。避免不必要的置管,及时拔除侵入性置管,加强对感染控制措施的依从性,预防不适当的抗生素使用,遵守隔离程序,并根据病原体的记录开始适当的抗生素治疗,将显著降低HAIs的发生率。
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Assessment of Healthcare Associated Infections in a Medical Intensive Care Unit
Objective: This study was undertaken to assess the current status of healthcare associated infections (HAIs) in our institution during a 2-year period in relation to causative agents and their distribution, use and duration of invasive mechanical ventilation, and infection rate and incidence in comparison with national data. Methods: Patients admitted to Medical ICUs of Meram State Hospital between 1st Jan 2019 and 31st Dec 2020 wereincluded. During a 2-year period a total of 47 patients were diagnosed with HAIs based on Centers for Disease Control and Prevention (CDC) and National Nosocomial Infection Surveillance Network (NNISN) criteria. Results: During 6041 follow-up days for 922 patients admitted to ICU, a total of 47 HAIs cases were detected. The most common types of HAIs included healthcare-associated pneumonia in 21 patients (45.6%) and other infections of the respiratory system in 12 patients (26.1%). The most common causative agent was Acinetobacter baumannii, which was found in 27 patients (50.9%). Conclusion: HAIs is an unavoidable condition in ICUs owing to a number of factors such as frequent use of invasive devices, prolonged length of admission, and increased number of complications. One of the major health targets in healthcare facilities is to control an manage HAIs. Avoidance from unnecessary catheterizations, timely removal of invasive catheters, increased adherence to infection control measures, prevention of inappropriate antibiotic use, compliance with isolation procedures, and initiation of appropriate antibiotherapy based on documentation of causative organisms will significantly reduce HAIs incidence.
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