Investigation on critically ill patients with nosocomial infection / 中国基层医药

ABSTRACT

Objective To determine epidemiology and risk factors for nosocomial infections in severe patients.Methods The study included 434 patients (7394 patient-days)during a 2-year period (2010-2011).The incidence rate of infection,pathogenic bacteria,correlation factor of infected were analyzed.Results A total of 225 infections were identified in 113 patients(26.0％).The incidence and infection rates were 56.8 in 1000-patient days and 51.8％,respectively.The infections were pneumonia (40.9％),bloodstream (30.2％),urinary tract (23.6％) and surgical site infections (5.3％).Pseudomonas aeruginosa (22.6％),methicillin-resistant Staphylococcus aureus (22.2％) and Acinetobacter spp.(11.9％) were frequently isolated micro-organisms.Median length of stay with nosocomial infection and without were 13 days (Interquartile range,IQR,20) and 2 days (IQR,2),respectively (P ＜ 0.01).In logistic regression analysis,mechanical ventilation[odds ratio(OR)16.35 ;95％ confidence interval(CI)8.26 ～32.34;P ＜0.01),coma(OR15.04;95％ CI3.41 ～66.33;P ＜0.01),trauma(OR10.27 ;95％ CI2.34～45.01 ;P ＜0.01),nasogastric tube(OR2.94 ;95％ CI1.47 ～ 5.90; P ＜ 0.01),tracheotomy (OR5.77 ;95％ CI1.10 ～30.20;P ＜0.05) and APACHE Ⅱ scores 10 ～ 19(OR10.80;95％ CI1.10 ～ 106.01 ;P ＜0.05) were found to be significant risk faetors for nosocomial infection.Rate of nosocomial infection increased with the number of risk factors(P ＜0.01).Mortality rates were higher in infected patients than in non-infected patients(60.9 vs 22.1％ ;P ＜0.01).Conclusion These data suggest that,in addition to underlying clinical conditions,some invasive procedures can be independent risk factors for nosocomial infection in ICU.