Hastane enfeksiyonları; sıklığı ve risk faktörleri

Amaç: Ege Üniversitesi Tıp Fakültesi (EÜTF) Hastanesi Çocuk Sağlığı ve Hastalıkları Kliniğinde yatan, yenidoğan servisi dışındaki hastalarda bir yıllık süre içinde gelişen hastane enfeksiyonlarının sıklığı, tipi, en sık sorumlu etkenler ile bu enfeksiyonların hasta yatış süresi üzerine etkilerinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Ocak 2002- Aralık 2002 tarihleri arasında EÜTF Çocuk Sağlığı ve Hastalıkları Kliniğinde Yenidoğan servisi dışında yatırılan ve izlemlerinde hastane enfeksiyonu tanısı alan hastalar çalışmaya alınmıştır. Hastane enfeksiyonu tanıları Center for Disease Control and Prevention (CDC)’nin kriterleri esas alınarak konulmustur. İstatistik analizlerinin hesaplanmasında SPSS 10.1 for Windows paket programı kullanıldı ve p

Pediatric nosocomial infections; incidence, risk factors

Aim: This study aimed to determine the prevalence and type of nosocomial infections, etiologic distrubition of organism in hospitalized children at Ege University School of Medicine, Department of Pediatrics for a 12 month period. It also investigated the duration of hospitalization. Material and Method: Patients diagnosed with nosocomial infection between January 2002-December 2002 at the inpatient unit of pediatrics were included in the study. Neonatal cases were excluded from the analysis. Diagnosis of nosocomoial infection was made based on CDC criteria. Statistical analysis was made by using SPSS 10.1 for Windows packet and p<0.05 was accepted as significant. Results: During the study period, 1811 patients were investigated and 96 nosocomial infection determined (5.3%). The majority were female at 52% (n=50). The most common infections in our study were bacteriemia and urinary tract infections, 50% and 40% respectively. Although bacteriemia was the commonest infection type in the intensive care unit, urinary tract infections were the most common infections in inpatient services. Enterobacteriaceae was the most common cause with 37.5% (n=36), coagulase negative staphylococci found in 16.4% (n=16) and yeast infection was isolated in 12.5% (n=12). The majority of patients (59.3% n=57) had one or more invasive procedures which make the patients susceptible to contracting nosocomial infections. Children who are hospitalized more than 7 days are more likely to have nosocomial infections (P<0.0001). Another predisposing factor for developing nosocomial infections was increased patient numbers receiving medical care by each nurse. Conclusion: Nosocomial infections have been increasing in pediatric patients. Long hospital stays and increased patient numbers needing medical care by each nurse were associated with nosocomial infections. They are estimated to more than double the mortality and morbidity risks of any admitted patient.

Kaynakça

1. Noone A, O’Brain SJ, National surveillance of hospital-acquired infection-can performance indicators be developed, J Hosp. Infect 1977; 37: 85-8.

2. Peşken Y. Hastane İnfeksiyonlarının Epidemiyoloji. İnfeksiyon Hastalıkları (KLIMIK) Dergisi 1993; 6: 100-1.

3. Korten V. Hastane İnfeksiyonlarının Epidemiyolojisi Ve Genel Risk Faktörleri. Erdal Akalın(ed). Hastane İnfeksiyonları. 1. Baskı, Güneş Kitabevi, Ankara 1993; 34-44.

4. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for Prevention of Surgical Site Infection 1999. Centers for Disease and Prevention, (CDC). Hospital Infection Control Practices Advisory Commitee. Am J Infect Control 1999; 27(1): 97-132.

5. Wilke A, Gündeş SG. Türkiye’de Enfeksiyon Kontrol Programları Ve Uygulamaları. Aktüel Tıp Dergisi 2001; 6: 1-6.

6. Ford-Jones EL, Mindorff CM, Langley JM, et al. Epidemiological study of 4684 hospital acquired infections in pediatric patients. Pediatr Infect Dis J 1989; 8: 668-75.

7. Harris J, A.S. Pediatric Nosocomial Infections: Children Are Not Little Adults. J Control Hosp Epidemiol 1997; 18: 739-42.

8. Wilke A, Başkan S, Palabıyıkoğlu İ, Erdem B, Köse T. Ankara Üniversitesi Tıp Fakültesi İbn-i Sina Hastanesi’nde 1992-1998 Yıllarında Gözlenen Hastane Enfeksiyonları. Hastane Enfeksiyonları Dergisi 2001; 5: 31-7.

9. Bakır M, Soysal A. Pediatrik Hastalarda Nozokomiyal İnfeksiyon Kontrolü, Türkiye Klinikleri, Pediatri (Özel Sayı) 2004; 2(3): 318-26.

10. Raymond J, Aujard Y. Nosocomial infections in pediatric patients: a European, multicenter prospective study. European Study Group. Infect Control Hosp Epidemiol 2000; 21: 260-3.

11. Levy J. The Pediatric Patient, In:Wenzel RP (ed). Revention and Control of Nosocomial Infections. Third edition, Williams & Wilkins, Baltimore, Maryland. 1997; 1039-59.

12. Spencer RC. Predominant Pathogens Found in the European Prevalance of Infection in Intensive Care Study. Eur J Clin Microbiol Infect Dis 1996; 15: 281-5.

13. Richards MJ, Edwards JR, Culver DH, Caynes RP. Nosocomial Infections in Combined Medical-Surgical Intensive Care Units in The United States. Infect Control Hosp Epidemiol 2000; 21: 510-5.

14. Wilke A. Hastane Enfeksiyonlarının Etkenleri ve Antibiyotik Duyarlılıkları. Ed: Akalın E. Hastane Enfeksiyonları, 1. Baskı, Ankara, Güneş Kitabevi 1993; 45-53.

15. Rezende EM, Couto BR, Starling CE, Modena CM. Prevalence of nosocomial infections in general hospitals in Belo Horizonte. Infect Control Hosp Epidemiol 1998; 19: 872-6.

16. Saltoğlu N, Öztürk C, Taşova Y, İncecik Ş, Paydaş S, Dündar İH. Yoğun Bakım Ünitelerinde Enfeksiyon Nedeniyle İzlenen Hastalarda Etkenler, Risk Faktörleri, Antibiyotik Direnci ve Prognozun Değerlendirilmesi. Flora 2000; 5: 229-37.

17. Ay P, Karabey S. El yıkama ve el dezenfeksiyonu. Aktüel Tıp Dergisi 2001; 6: 52-6.

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