Healthcare-associated infections: prospective rotational surveillance data of a training and research hospital

Y. Çekli, Şaban Çavuşoğlu
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Abstract

Aims: Monitoring and prevention of healthcare-associated infections (HAI) are considered to be one of the key measures to improve the effectiveness and quality of healthcare services. This study aimed to ascertain the prevalence of HAI in various hospital departments, identify the causative bacterial profile, risk factors, and the association with mortality. Methods: This prospective study included 3117 patients who were monitored in various departments of a Training and Research Hospital. The identified HAI cases were monitored using an active, prospective, rotational surveillance method. Patient data on HAI was daily recorded on pre-established tracking forms. Results: The mean hospital stay of patients was 9.9±7.5 days. The HAI prevalence was 4.5% and the HAI rate was 5.5%. The HAI rate showed no difference between internal medicine and surgical departments (5.7% vs 5.5%, p>0.05), but it was higher in intensive care units (ICU) (p<0.001). The majority of the isolated agents (65.2%) were gram-negative bacteria. Advanced age, intrinsic risk factors such as malignancy, and invasive procedures (use of central, peripheral, and urinary catheters) were associated to the development of HAI. The frequency of HAI was higher in deceased patients compared to survivors (25.4% vs 4.1%, p<0.001). Conclusion: HAI remains a major concern in hospital settings, particularly in ICU, and strongly correlates with intrinsic risk factors and invasive procedures. Optimized infection control measures with these risk factors can make a significant contribution to improving patient outcomes.
医疗保健相关感染:一家培训与研究医院的前瞻性轮转监测数据
目的:监测和预防医疗相关感染(HAI)被认为是提高医疗服务效率和质量的关键措施之一。本研究旨在确定 HAI 在医院各科室的流行情况,确定致病细菌的特征、风险因素以及与死亡率的关系:这项前瞻性研究纳入了一家培训与研究医院各科室监测的 3117 名患者。采用主动、前瞻性、轮换监测方法对已确定的 HAI 病例进行监测。病人的 HAI 数据每天都记录在预先制定的跟踪表格中:结果:患者的平均住院日为 9.9±7.5 天。HAI 感染率为 4.5%,HAI 发生率为 5.5%。内科和外科的 HAI 感染率没有差异(5.7% vs 5.5%,p>0.05),但重症监护室(ICU)的 HAI 感染率更高(p<0.001)。大多数分离出的病原体(65.2%)为革兰氏阴性菌。高龄、恶性肿瘤等内在风险因素和侵入性操作(使用中央、外周和导尿管)与 HAI 的发生有关。与幸存者相比,死亡患者发生 HAI 的频率更高(25.4% 对 4.1%,P<0.001):HAI仍然是医院环境中的一个主要问题,尤其是在重症监护室,它与内在风险因素和侵入性程序密切相关。针对这些风险因素采取优化的感染控制措施可为改善患者预后做出重大贡献。
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