کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3364615 1592138 2009 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Infections in a surgical intensive care unit of a university hospital in Greece
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی میکروبیولوژی و بیوتکنولوژی کاربردی
پیش نمایش صفحه اول مقاله
Infections in a surgical intensive care unit of a university hospital in Greece
چکیده انگلیسی

SummaryObjectivesWe aimed to evaluate the clinical and microbiological characteristics of the patients who developed an infection in our surgical intensive care unit (SICU).MethodsThis was a prospective study of all patients who sustained an ICU-acquired infection from 2002 to 2004.ResultsAmong 683 consecutive SICU patients, 123 (18.0%) developed 241 infections (48.3 infections per 1000 patient-days). The mean age of patients was 66.7 ± 3.8 years, the mean APACHE II score (acute physiology and chronic health evaluation) on SICU admission was 18.2 ± 2.4, and the mean SOFA score (sepsis-related organ failure assessment) at the onset of infection was 8.8 ± 2. Of the study patients, 51.2% were women. Infections were: bloodstream (36.1%), ventilator-associated pneumonia (VAP; 25.3%, 20.3/1000 ventilator-days), surgical site (18.7%), central venous catheter (10.4%, 7.1/1000 central venous catheter-days), and urinary tract infection (9.5%, 4.6/1000 urinary catheter-days). The most frequent microorganisms found were: Acinetobacter baumannii (20.3%), Pseudomonas aeruginosa (15.7%), Candida albicans (13.2%), Enterococcus faecalis (10.4%), Klebsiella pneumoniae (9.2%), Enterococcus faecium (7.9%), and Staphylococcus aureus (6.7%). High resistance to the majority of antibiotics was identified. The complication and mortality rates were 58.5% and 39.0%, respectively. Multivariate analysis identified APACHE II score on admission (odds ratio (OR) 4.63, 95% confidence interval (CI) 2.69–5.26, p = 0.01), peritonitis (OR 1.85, 95% CI 1.03–3.25, p = 0.03), acute pancreatitis (OR 2.27, 95% CI 1.05–3.75, p = 0.02), previous aminoglycoside use (OR 2.84, 95% CI 1.06–5.14, p = 0.03), and mechanical ventilation (OR 3.26, 95% CI: 2.43–6.15, p = 0.01) as risk factors for infection development. Age (OR 1.16, 95% CI 1.01–1.33, p = 0.03), APACHE II score on admission (OR 2.53, 95% CI 1.77–3.41, p = 0.02), SOFA score at the onset of infection (OR 2.88, 95% CI 1.85–4.02, p = 0.02), and VAP (OR 1.32, 95% CI 1.04–1.85, p = 0.03) were associated with mortality.ConclusionsInfections are an important problem in SICUs due to high incidence, multi-drug resistance, complications, and mortality rate. In our study, APACHE II score on admission, peritonitis, acute pancreatitis, previous aminoglycoside use, and mechanical ventilation were identified as risk factors for infection development, whereas age, APACHE II score on admission, SOFA score at the onset of infection, and VAP were associated with mortality.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Infectious Diseases - Volume 13, Issue 2, March 2009, Pages 145–153
نویسندگان
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