頁籤選單縮合
題名 | 南部某區域教學醫院加護中心與普通病房之院內感染比較=Nosocomial Infections in Intensive Care Units and General Wards at a Regional Hospital in Southern Taiwan |
---|---|
作者姓名(中文) | 簡素娥; 郭國基; 黃情川; 林水龍; | 書刊名 | 院內感染控制雜誌 |
卷期 | 11:6 2001.12[民90.12] |
頁次 | 頁365-375 |
分類號 | 419.38 |
關鍵詞 | 院內感染; 加護中心; Nosocomial infection; Intensive care units; |
語文 | 中文(Chinese) |
中文摘要 | 醫療技術的進步,使得人類生命得以延長,但醫院是感染疾病的場所,尤其是加護病房病情嚴重度增加、又是高危險群、而且侵入性醫療措施多,因此加護中心的院感染率比普通病房高北是眾所週知之事。我們針對一區域教學醫院由1997至1999年的院內感染資料加以整理分析。該院病床數484張,依美國CDC 1988年院內感染定義收案,採回溯、主動性的調查方式,束理1997年至1999年三年來,本院加護中心及普通病房之院內感染個案狀況,計算兩種不同型式病房之感染率、分析感染菌種的特性、並比較感染部位分佈的情形。結果顯示,三年間總出院人數為20,140人次,院內感染人次共722人次,平均感染密度為3.8?,其中有194人次發生於加護中心,其感染密度19.38?為普通病房2.95?的6.6倍。院內感染菌株898株中,加護中心以pseudomonas aeruginosa居導,其次為Staphylococcus aureus,普通病房則以S. AUREUS佔第一位,其次是P. aeruginosa;但是第三名菌株則加護中心為Acintobacter baumannii,普通病房為Escherichia coli有所不同。感染部位不管是加護中心或普通病房均以呼吸道感染佔第一位,其次泌尿道感染。由以上結果我們認為加護中心病患較易得到院內感染,本院加護中心A. baumannii及血流感染的問題值得重視,另本院呼吸道院內感染不論在一般病房及加護病房都異常的多,其原因除了病人有五分之一有慢性呼吸道宿疾外,是否仍有其他原因則有待進一步探討。 |
英文摘要 | A retrospective study of the nosocomial infections was carried out at a 484-bed "regional teaching hospital" in southern part of Taiwan. The study covered a 3-year period from 1997 till 1999. Active surveillance of the infections, according to the definitions of the US Centers of Diseases Control, was carried out by a professional infection control nurse during the period. There were 722 nosocomial infections among 20, 140 patients hospitalized for a total of 188,996 patient-days, with the infection density of 3.8?. The results were analyzed according to those that occurred in the intensive care units (ICU) and those in the general wards, and the two groups of data compared. There were significantly higher proportions of patients with the risk factors for infection among those admitted to ICU than those to the wards. These factors include: patients over 65 years of age (94.6% vs. 68.3%); patients with cardiovascular diseases (27.5% vs. 10.1%);chest diseases (31.3% vs. 22.2%); Foley catheter placement (82.8% vs. 26.4%); central venous catheter insertion (49.1% vs. 11.1%); and ventilator usage (60.1% vs. 18.7%). The nosocomial infection densities for the two groups were 19.38? and 29.5%, respectively, 6.6times higher in the ICU than in the general wards. 898 stains of microorganisms were isolated from these patients. 64.4% was Gram-negative bacteria; 28.8% Gram-positive; and 6.4% fungi. Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii, and Klebsiella pneumoniae were the major organisms. Methicillin-resis-tant S. aureus infection was not increased during these three years, whereas the infection by A. baumannii did. The lower respiratory infections were the most common form of nosocomial infections in both ICU and the wars. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。