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題名 | 院內泌尿道感染之調查表=Nosocomial Urinary Tract Infections over a 10-Year Period at a Medical Center |
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作者 | 施秀; 蘇琴玲; 吳劍清; 羅世慧; 駱惠銘; | 書刊名 | 院內感染控制雜誌 |
卷期 | 8:1 1998.02[民87.02] |
頁次 | 頁400-411 |
分類號 | 419.38 |
關鍵詞 | 院內泌尿道感染; 抗生素感受性試驗; 導尿管; Nosocomial urinary tract infections; Antimicrobial susceptibility test; Urinary catheters; |
語文 | 中文(Chinese) |
中文摘要 | 為了解本院近年來院內泌尿道感染病患的致病因素、合併症與死亡率、個案住院天數與感染菌種及與抗生素感受性試驗結果的變化。我們回溯式的調查,統計了近十年內1,061名院內泌尿道感染個案資料,總感染發生率為0.8%(人次/住院病患數),0.7□(人次/住院天數)。住院病患的院內泌尿道感染發生率隨著年齡的增加而上升,加護病房的發生率非加護單位高。以病患的原發疾病來分,以神經系統疾病病患最多(18.1%),其次為腸胃道疾病(12.6%)與癌症病患(9.6%)。最常見的致病菌為大腸桿菌、綠膿桿菌、念珠菌、肺炎克雷白氏桿菌與腸球菌。近五年內各種微生物的抗生素感受性都有明顯的下降。由院內泌尿道感染繼發的菌血症發生率為35.6(人/每十萬人),有兩名病患死亡。 |
英文摘要 | A retrospective study of nosocomial urinary tract infections (NUTI) was carried out at a medical center in Taiwan covering the period from 1987 till 1996. A total of 132,007 cases were admitted, of those nosocomial infections developed in 4,069 cases (3.08%). NUTI developed in 1,061 cases (16.1%), 0.8 % of the total hospitalized patients. 69.5% of the patients had urine cultures. Those with colony count<10□/mL and with more than 3 kinds of microorganisms were excluded. The results showed that 51.7% were males; and the average age was 61 years old, in contrast to 37 years old for all hospitalized patients. The incidence increased by age, from 0.16% for 0 ~ 10 years old to 6.48% for those above 90 years old. It developed more often among the intensive care unit (ICU) patients than the non-ICU patients (2.26% vs 0.73%). Patients in the medical wards, rehabilitation, and surgical wards had the highest incidences, 2.28%, 1.67%, and 1.18%, respectively. Patients with neurological diseases, cancer, and gastrointestinal disorders constituted most of the cases, 18.1%, 12.6%, 12.6%, respectively. The species of microorganisms in the urine culture was the same as those in the other infected sites of the patient in 42.4%. The average duration of the hospital stay till the development of NUTI was 26 ±37 days, whereas the average total hospital stay of all patients was 11 ±18 days. Urinary tract invasive procedures were carried out within one week prior to the development of the NUTI in 91.8% of the cases; of those, long-term indwelling catheter consisted 84.2%. The average duration of the catheter in the bladder was l6 ±27 days. Pathogens were 73.3% Gram-negatives, 10.6% Gram-positives and 16.1% Candida species. Escherichia coli, Pseudomonas aeruginosa, and Klebsiealla pneumoniae constituted 20.5%, 15.5% and 8.5%, respectively. Comparing the pathogens in cases of the first 5 years and the latter 5 years, there was a significant rise in the number of candida species (12 vs 58); and there were obvious decreases in the antimicrobial susceptibility. These results are in accordance with those of others, and emphasize the importance of the avoidance of indwelling urinary catheter in the prevention of the NUTI. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。