Yoğun Bakım Ünitesindeki Hastane İnfeksiyonlarının Değerlendirilmesi

Abstract

Evaluation of Nosocomial Infections in Intensive Care Unit Nosocomial infections (Nl) constitute an important health problem with prolongation of hospital stay, increased costs of direct care, morbidity and high mortality. The aim of this study was to evaluate the general features of NI in Mikail Yuksel Intensive Care Unit (ICU) in Ondokuz Mayis University. A cross sectional research was performed between 1st September 1998 and 28U1 February 1999 in Mikail Yuksel ICU in Ondokuz Mayis University. Medians of age and total lenght of hospital stay in patients with NI were 47 years (18-67 years) and 28 days (12-84 days), respectively. Medians of total length of hospital in patients witihout NI were 6 days (2-21 days) and there was a statistically significant difference between two group (p<0.001). The patient's day was found 332 days. NI rate was found 10.7% and the principal sites of NI were the urinary tract (36.4%), bacteriemia (27.3%), pneumonia (18.2%) and local vascular cauiater (18.2%). Vascular cathaterization was performed on 100.0% and urinary cathaterization, entubatioii and mechanic ventilation were performed on 90.9% of the patients. We conclude that the high economic expense, long hospitalization periods, high mortality rates which NI represent emphasized the necessity of carefully designed and conducted studies in the control of these infections. Hastane infeksiyonlari (HI) hastanede kalis surelerinin uzamasi, yuksek hasta bakim maliyeti, morbidite ve mortalite riski nedeniyle onemli bir saglik sorunudur. Calismada Ondokuz Mayis Universitesi Tip Fakultesi Mikail Yuksel Cerrahi Yogun Bakim Unitesi (YBU)'nde gorulen HI'larinin degerlendirilmesi amaclanmistir. Kesitsel tipteki bu arastirma Ondokuz Mayis Universitesi Tip Fakultesi Mikail Yuksel Cerrahi YBU'nde, 1 Eylul 1998-28 Subat 1999 tarihleri arasinda yapilmistir. HI olan hastalarin yaslarinin ortancasi 47 yil (18-67 yil), hastanede yatis suresi ortancasi 28 gun (12-84 gun) olup, hasta gunu 332 gun olarak bulunmustur. HI olmayan es grubun hastanedeki yatis suresi ortancasi 6 gun (2-21 gun) olup, iki grup arasinda yatis suresi acisindan istatistiksel anlamli fark bulunmustur (p<0.001). HI orani %10.7 olup, bu taniyi alan hastalarin %36.4'unde uriner sistem infeksiyonu, %27.3'unde bakteriyemi. %18.2'sinde pnomoni ve %18.2'sinde lokal kateter infeksiyonu saptanmistir. Invaziv girisimlerden santral venoz kateter hastalarin %100.0'une, uriner kateter, entubasyon ve mekanik ventilasyon %90.9'una uygulanmistir. HI'larinin yol actigi ek maliyet, yatis suresi ile mortalite oranlarindaki artis gozonunde bulunduruldugunda bu infeksiyonlarin kontrolune yonelik calismalara agirlik verilmesi geregi bir kez daha ortaya cikmaktadir.