Nosocomial Infection and Correlated Risk Factors of Death in a Surgical Intensive Care Unit / 中华医院感染学杂志

ABSTRACT

OBJECTIVE To investigate the occurrence of nosocomial infection and the correlated risk factors of death in patients admitted to the Surgical Intensive Care Unit(SICU) of Peking University First Hospital.METHODS The clinical data of the occurrence,sites,and pathogenic microorganisms of nosocomial infection in patients(admitted) to the SICU from Jan 2002 to Jan 2005 were analyzed retrospectively,and the correlated risk factors of death in patients with nosocomial infection were screened by Logistic regression analysis.RESULTS Nosocomial infection occurred in 4.2% patients admitted to the SICU.The mortality of patients with nosocomial infection was(48.9%.) The most frequent sites of infection were lower respiratory tract(88.9%),hematological system((48.9%),) and urinary tract(26.7%).The most prevalent pathogens of infection were Gram-negative(bacteria)((64.1%),) including Pseudomonas aeruginosa,Stenotrophomonas maltophilia,Acinetobacter calcoaceticus-(baumannii) complex and Klebsiella oxytoca.Gram-positive bacteria accounted for 24.8%,including MRSA,MRSE,and Enterococcus faecium.Fungi accounted for 11.1%,of which Candida albicans was the most frequent one.(Multidrug) resistance was an important character of the pathogens of nosocimal infection of SICU.(Aggregate)(analysis) of the correlated risk factors of death showed there were three indenpedent risk factors,including mental disturbance,hypotension,and acute renal failure(P=0.015,0.028,and 0.003,respectively).CONCLUSIONS Careful monitoring should be made for infections of lower respiratory tract,hematological system and urinary tract for patients in the SICU.The species diversity and multidrug resistance of pathogens of nosocomial infection in the SICU make it difficult to initiate the early empirical antibiotic therapy.Empirical selection of antibiotics should be made according to the local data of species and susceptibility patterns of pathogens of nosocomial infection.Mental disturbance,hypotension and acute renal failure are three independent risk factors of death for patients with(nosocomia)l infection in SICU.