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Nosocomial infections and risk factors in intensive care unit of a university hospital

机译:高校医院重症监护室的医院感染及危险因素

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Objective: The aim of this study is to evaluate nosocomial infections (NIs) in intensive care unit (ICU) in terms of site of infection, distribution of pathogens and risk factors for developing infection. Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard microbiologic methods. Results: Of 56 patients who have developed NIs, 26 (50%) had pneumonia, 15 (28.8%) had bloodstream infections and 6 (11.5%) had urinary tract infections. Klebsiella pneumoniae (23.5%), Pseudomonas aeruginosa (19.6%), and Acinetobacter spp. (15.6%) were the most frequently isolated microorganisms, respectively. For Klebsiella pneumoniae isolates, extended spectrum beta lactamase (ESBL) rate was 91.6%, carbapenem resistance rate was 15.6% and for Pseudomonas aeruginosa and Acinetobacter spp . carbapenem resistance rates were 60% and 100% respectively. Hemodialysis, enteral nutrition, total parenteral nutrition and prolonged hospitalization for more than 10 days were determined as independent risk factors for developing NI. Additionally Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of ICU stay and lenght of hospital stay before ICU were found to be high in the NI group. Conclusion: Pneumonia is the most common NI and carbapenem resistance in Gram-negative bacilli was remarkably high in our ICU. It was considered that infection control measures must be applied carefully, invasive procedures should be used in correct indications and we should avoid long-term hospitalization if unnecessary.
机译:目的:本研究旨在评估重症监护病房(ICU)的院内感染(NIs),包括感染部位,病原体分布和发生感染的危险因素。方法:本研究包括80例在ICU中停留超过48小时的患者。注意到患者的流行病学特征,侵入性程序和其他危险因素。通过标准微生物学方法进行培养,分离株鉴定和抗生素敏感性试验。结果:在56例发生NI的患者中,有26例(50%)患有肺炎,其中15例(28.8%)患有血流感染,而6例(11.5%)患有尿路感染。肺炎克雷伯菌(23.5%),铜绿假单胞菌(19.6%)和不动杆菌属。 (15.6%)分别是最常分离的微生物。对于肺炎克雷伯菌分离株,扩谱β-内酰胺酶(ESBL)率为91.6%,碳青霉烯耐药率为15.6%,铜绿假单胞菌和不动杆菌属。碳青霉烯耐药率分别为60%和100%。血液透析,肠内营养,全胃肠外营养和住院时间超过10天被确定为发展为NI的独立危险因素。此外,NI组的急性生理和慢性健康评估(APACHE)II评分,重症监护病房(ICU)住院时间和住院时间长在ICU中较高。结论:肺炎是最常见的NI,革兰氏阴性杆菌中的碳青霉烯耐药性在我们的ICU中非常高。有人认为必须谨慎地采取感染控制措施,在正确的适应症中使用侵入性程序,如果不必要,我们应该避免长期住院。

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