Nosocomial infection incidence in surgical patients in the intensive care unit

UVOD: Bolesnici su tijekom boravka u zdravstvenoj ustanovi izloženi riziku nastanka bolničkih infekcija. Rizik je osobito velik za kritično oboljele u jedinicama intenzivne skrbi zbog izloženosti bolesnika brojnim invazivnim dijagnostičkim i terapijskim postupcima od kojih su najznačajniji: bolnička infekcija izazvana centralnim venskim kateterom, upala pluća izazvana primjenom strojne ventilacije i infekcija izazvana urinarnim kateterom. ----- CILJ ISTRAŽIVANJA: Utvrditi učestalost infekcija povezanih s invazivnim terapijskim postupcima praćenja bolesnika te ispitati koji su najčešći uzročnici infekcija. ----- REZULTATI: Od 1. siječnja 2014. do 31. prosinca 2016. godine na Odjelu intenzivnog liječenja kirurških bolesnika KB Sveti Duh ukupno su primljena 2 251 bolesnika. Ostvarena su 8 782 bolesnička dana s prosjekom ležanja 3,62 dana. Broj bolesnika koji su strojno ventilirani iznosi 533 od kojih je 16 razvilo upalu pluća izazvanu strojnom ventilacijom. Ukupni mortalitet je 7,06%. Učestalost infekcija povezanih s urinarnim kateterom iznosi 26. ----- ZAKLJUČAK: Bolničke infekcije važan su pokazatelj zdravstvene skrbi te predstavljaju sve važniji problem moderne zdravstvene zaštite; produžuju trajanje liječenja i vrijeme boravka u bolnici. Rizik za pojavu bolničkih infekcija povećava se s brojem terapijskih postupaka i duljinom njihove primjene. Najzastupljenija infekcija povezana s invazivnim terapijskim postupcima je infekcija izazvana urinarnim kateterom. Najčešći uzročnik infekcija je Acinetobacter baumannii.INTRODUCTION: During the hospital stay, patients are exposed to risk factors for nosocomial infections. The risks are particularly increased in those who are placed in the ICU, because the patients are exposed to numerous invasive diagnostic and therapeutic procedures. Some of the most significant risk factors arise from invasive central venous catheters, mechanical ventilators causing pneumonias and urinary catheters causing urinary tract infections. ----- OBJECTIVES: To determine the frequency of infections related to invasive therapeutic methods and to discover their most frequent causes. ----- RESULTS: Data was obtained from the Surgical Department ICU in the Clinical Hospital “Sveti Duh“ from January 1, 2014 until December 31, 2016. Two thousand and fifty one patients were admitted. These patients were hospitalized for a total of 8,782 days, with an average stay of 3.62 days. The number of patients who were on mechanical ventilation was 533, while 16 of them developed VAP. The total mortality was calculated to be 7.06%. Incidence of catheter-associated urinary tract infection was 26. ----- CONCLUSION: Hospital infections are good indicators of healthcare and they represent an increasing problem in modern healthcare; they prolong treatment duration and duration of hospital stay. Risk of acquiring nosocomial infections is increased by the number of therapeutic procedures and the duration of their implementation. The most common infection associated with invasive therapeutic procedures was caused by the urinary catheter. The most common bacterium was Acinetobaacter baumannii