医院相关感染(HAI)在重症监护病房(ICU)中非常常见,通常与患者使用侵入性设备有关。这项研究是为了确定哈萨克斯坦外科ICU中HAI的患病率和病因。并评估这些感染对ICU住院时间和死亡率的影响。
为了评估阿斯塔纳国家肿瘤和移植研究中心(NRCOT)ICU中设备相关感染和致病HAI病原体的发生率,哈萨克斯坦。
这次回顾展,观察性研究是在NRCOT的12张病床的ICU中进行的,阿斯塔纳,哈萨克斯坦。我们招募了所有从1月开始入住ICU的患者,2014年至2015年11月,年龄在18至90岁之间,患有HAI。
最常见的HAI类型是手术部位感染(SSI),其次是呼吸机相关性肺炎(VAP),导管相关性血流感染(BSI)和导管相关性尿路感染(UTI)。最常见的HAI是SSI,铜绿假单胞菌是最常见的病原体。第二个最常见的HAI是VAP,也是铜绿假单胞菌,其次是BSI,也与铜绿假单胞菌(2014年)和粪肠球菌有关。和肺炎克雷伯菌(2015年)是引起这些感染的最常见病原体。
我们发现,在我们的研究人群中,HAI主要是由革兰氏阴性病原体引起的,包括铜绿假单胞菌,肺炎克雷伯菌,和大肠杆菌。据我们所知,这是唯一一项描述中亚地区某个国家与ICU相关的HAI情况的研究.哈萨克斯坦等许多发展中国家缺乏可以有效降低HAIs发生率和治疗医疗费用的监测系统。目前,哈萨克斯坦关于HAI的流行病学数据代表性不足,文献报道也很少。基于此和以前的研究,我们建议在NRCOT和哈萨克斯坦的类似医疗机构中预防HAI的最重要干预措施是积极监测,定期感染控制审计,合理有效的抗菌治疗,和一般卫生措施。
Hospital Associated infections (HAI) are very common in Intensive Care Units (ICU) and are usually associated with use of invasive devices in the patients. This study was conducted to determine the prevalence and etiological agents of HAI in a Surgical ICU in Kazakhstan, and to assess the impact of these infections on ICU stay and mortality.
To assess the rate of device-associated infections and causative HAI etiological agents in an ICU at the National Research Center for Oncology and Transplantation (NRCOT) in Astana, Kazakhstan.
This retrospective, observational study was conducted in a 12-bed ICU at the NRCOT, Astana, Kazakhstan. We enrolled all patients who were admitted to the ICU from January, 2014 through November 2015, aged 18 to 90 years of age who developed an HAI.
The most common type of HAI was surgical site infection (SSI), followed by ventilator-associated pneumonia (VAP), catheter-related blood stream infection (BSI) and catheter-associated urinary tract infection (UTI). The most common HAI was SSI with Pseudomonas aeruginosa as the most common etiological agent. The second most common HAI was VAP also with P. aeruginosa followed by BSI which was also associated with P. aeruginosa (in 2014) and Enterococcus faecalis, and Klebsiella pneumoniae (in 2015) as the most common etiological agents causing these infections.
We found that HAI among our study population were predominantly caused by gram-negative pathogens, including P. aeruginosa, K. pneumoniae, and E. coli. To our knowledge, this is the only study that describes ICU-related HAI situation from a country within the Central Asian region. Many developing countries such as Kazakhstan lack surveillance systems which could effectively decrease incidence of HAIs and healthcare costs for their treatment. The epidemiological data on HAI in Kazakhstan currently is underrepresented and poorly reported in the literature. Based on this and previous studies, we propose that the most important interventions to prevent HAI at the NRCOT and similar Healthcare Institutions in Kazakhstan are active surveillance, regular infection control audits, rational and effective antibacterial therapy, and general hygiene measures.