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  • Title: [Monitoring of nosocomial infections in intensive care units].
    Author: Wieder-Huszla S.
    Journal: Ann Acad Med Stetin; 2010; 56(3):20-9. PubMed ID: 22053623.
    Abstract:
    INTRODUCTION: Intensive care units (ICUs) are distinguished by the use of specialist medical procedures based on invasive monitoring and mechanical support of dysfunctional organs or systems of the body. Patients at ICUs represent a specific group due to the fact that many of them will suffer infections in the course of hospitalization which pose a threat to their health or life and exert an impact on the therapeutic success. The aim of this study was to perform a prospective analysis of hospital infections at the intensive care unit, to determine etiologic factors and clinical forms of infection, as well as to define infection risk factors specific for the patient or related to the diagnosis, treatment, and specific procedures at the unit. MATERIAL AND METHODS: The study was done in 234 patients hospitalized at the Department of Intensive Medical Care, Pomeranian Medical University, Independent Public Clinical Hospital No. 1 in Szczecin during one year. An infection registration card was created for each patient. Samples for microbiological tests were routinely collected once a week or in the event of suspected infection. CONCLUSIONS: 1. The prospective clinical, microbiological, and epidemiologic analysis performed at the ICU demonstrated that: a) infections were diagnosed in approx. 45% of the patients, b) the most common clinical forms of infection were: pneumonia (87.5%), sepsis (44.2%), and urinary tract infection (36.5%). Two to four clinical forms of infection were seen in approx. 64% of the patients, c) the most common etiologic factor of infection, irrespectively of the clinical form, were Gram-negative bacteria, predominantly Acinetobacter baumannii and Pseudomonas aeruginosa, d) patient-related infection risk factors of importance included male gender and overweight/obesity, e) procedure--related infection risk factors considerably contributing to infection included: bronchial toilet, tracheostomy, drainage of body cavities, feeding through a gastric tube, gastrostomy, central vessel cannulation, parenteral feeding, and chemotherapy. 2. The understanding of the prevalence and circumstances of infections at ICUs will help verify standards of preventive and therapeutic management at the ICU and may contribute to adequate control and efficient treatment of infections.
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