印度新德里一家拥有1000张床位的三级护理教学医院的手术部位感染

Inam Danish Khan, Akanksha Yadav, U. Kapoor, I. Joshi, R. Pandey, A. Naik, J. Prakash, A. Chowdhury, M. Brijwal, G. Gonimadatala, N. Bhuttay, Anuradha Makkar
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摘要

背景:手术部位感染(SSI)包括任何手术后48小时发生的感染,占外科中心医疗保健相关感染(HAIs)的大部分。手术部位感染可导致疼痛、不适、延长住院时间、增加抗微生物药物暴露,并因此增加医疗保健费用。目的:本研究旨在描述新德里一家拥有1000个床位的三级教学医院SSI的发病率、病因和新出现的耐药性。方法:在新德里一所拥有1000个床位的三级教学医院进行双视角研究。使用美国疾病控制和预防中心(CDC)给出的国家医疗保健安全网络(NHSN)定义和方法对医疗保健提供者(HCPs)进行临床、实验室和环境监测和筛查。结果:本院妇产科和普通外科共收治3541例患者,SSI总发作80次(2.26%)。浅表、深部和器官间隙SSI的平均发生率分别为46.25%、47.5%和6.25%。最常见的细菌是鲍曼不动杆菌(23.75%)、铜绿假单胞菌(17.5%)、大肠杆菌(15%)和金黄色葡萄球菌(12.5%)。结论:在我们的研究中,SSI的发生率与世界范围内印度、中下、中上和高收入国家的未调整发生率相当。既往存在内科疾病、手术时间延长和伤口污染的患者极易发生手术部位感染。
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Surgical Site Infection in a 1000-Bed Tertiary-Care Teaching Hospital in New Delhi, India
Background: Surgical site infection (SSI) includes infections occurring after 48 hours of any surgery and accounts for most of the healthcare-associated infections (HAIs) in surgical centers. Surgical site infections can result in pain, discomfort, prolonged hospital stay, increased exposure to antimicrobials, and consequentially, increased healthcare costs. Objectives: The study intended to characterize the incidence, etiology, and emerging resistance of SSI in a 1000-bed tertiary-care teaching hospital in New Delhi. Methods: The ambispective study was conducted in a 1000-bed tertiary-care teaching hospital in New Delhi. Clinical, laboratory, and environmental surveillance and screening of health care providers (HCPs) were conducted using the National Healthcare Safety Network (NHSN) definitions and methods given by the US Centers for Disease Control and Prevention (CDC). Results: With 3,541 patients admitted to the Gynecology and Obstetrics Ward and General Surgical Ward of the hospital, the total episodes of SSI were 80 (2.26%). The mean rates of superficial, deep, and organ space SSI were 46.25%, 47.5%, and 6.25%, respectively. The most common organisms isolated were Acinetobacter baumannii (23.75%), Pseudomonas aeruginosa (17.5%), Escherichia coli (15%), and Staphylococcus aureus (12.5%). Conclusions: The rate of SSI in our study was comparable to the unadjusted rates in India, lower-middle, upper-middle, and high-income countries worldwide. Patients with pre-existing medical illness, prolonged operation time, and wound contamination are strongly predisposed to surgical site infection.
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