Læknablaðið - 15.01.1996, Side 62

46
LÆKNABLAÐIÐ 1996; 82
Sýkingar á gjörgæsludeild
Borgarspítalans
Alma D. Möller11, Sigurður Guðmundsson21, Kristín Gunnarsdóttir3), Ólafur Þ. Jónsson3’
MöIIer AD, Guömundsson S, Gunnarsdóttir K,
Jónsson ÓÞ
Infections in the Intcnsivc Care Unit in Reykjavík
City Hospital
Læknablaðið 1996; 82: 46-52
Objective: To identify infection rates, sites, patho-
gens, modes of acquisition and outcome in the In-
tensive Care Unit (ICU) of Borgarspítalinn.
Patients and methods: Two hundred patients admit-
ted longer than 24 hours were studied prospectively.
Definitions of infections were based on criteria from
the Centers of Disease Control.
Results: Seventy eight patients (39%) had a total of
128 infections. Sixty one percent were ICU ac-
quired, 19% community acquired and 23% were
other nosocomial infections. Thus, 24% of the pa-
tients developed an ICU acquired infection. The
most common infections were pneumonia 30%, uri-
nary tract infection 30%, septicemia 7% and intra-
abdominal infections 7%. The most common orga-
nisms isolated were S. epidermidis, E. coli, entero-
cocci, S. aureus, S. pneumoniae, H.influenzae and
P. aeruginosa. Infected patients stayed significantly
longer in the unit, 7.9 days, but non- infected pa-
tients stayed 2.9 days. Infections were not related to
age or gender, but were significantly associated with
tracheal intubation, central lines, treatment with
/7,-blockers, and underlying heart- or lung disease.
Frá '’svæfinga- og gjörgæsludeild Háskólasjúkrahússins í
Lundi, Svíþjóö, 2,lyflækningadeild Landspítalans, 3)svæf-
inga- og gjörgæsludeild Borgarspítalans. Fyrirspurnir og
bréfaskipti: Sigurður Guömundsson, lyflækningadeild
Landspítalans, 101 Reykjavík.
Lykilorö: Gjörgæsludeild, sýkingar.
Niðurstööur þessarar rannsóknar voru kynntar á vegg-
spjaldi (poster) á þingi norrænna svæfingaíækna i Reykja-
vík (júní 1995. (23rd Congress of the Scandinavian Society
of Anaesthesiologists. Reykjavík, lceland, June 12-16,
1995.) Ágrip birtist í: Acta Anaesthesiologica Scandinavica
1995; 39/Suppl. 105:156c, ágrip 84.
ICU mortality for infected patients was 13%, for
non-infected patients 7% (p=ns), but 81% and 91%
of infected and non- infected patients, respectively,
survived to hospital discharge (p<0.05).
Conclusions: Nearly 40% of the ICU patients had an
infection in the unit, 24% of the patients with ICU
acquired infections. The need for continuing specific
and accurate control and prevention of infections in
the ICU setting is clear.
Correspondence: Sigurður Guðmundsson, Depart-
ment of Medicine, Landspítalinn/National Universi-
ty Hospital, 101 Reykjavík, Iceland. E-mail: SIG-
GUDM.@RSP.IS. '
Ágrip
Tilgangur: Að kanna tíðni, sýkingarstaði,
orsakir og tilurð sýkinga á gjörgæsludeild
Borgarspítalans.
Sjúklingar og aðferðir: Gerð var framsæ at-
hugun á 200 sjúklingum sem lágu inni lengur en
sólarhring. Stuðst var við skilmerki frá Centers
of Disease Control, Atlanta við skilgreiningar
á sýkingum.
Niðurstöður: Sjötíu og átta sjúklingar (39%)
greindust með samtals 128 sýkingar. Sextíu og
eitt prósent voru gjörgæslusýkingar, 19% ut-
anspítalasýkingar og 23% aðrar spítalasýking-
ar. Gjörgæsludeildarsýkingu fengu því 24%
sjúklinganna. Algengustu sýkingarnar voru
lungnabólga (30%), þvagfærasýkingar (30%),
blóðsýkingar (7%) og kviðarholssýkingar
(7%). Algengustu sýklarnir voru S. epidermid-
is, E. coli, enterókokkar, S. aureus, S. pneu-
moniae, H. influenzae og P. aeruginosa. Lengd
innlagna var marktækt lengri í sýkta hópnum
(7,9 dagar) en í ósýkta hópnum (2,9 dagar).
Sýkingar voru ekki tengdar aldri eða kyni en
reyndust marktækt algengari hjá sjúklingum
sem höfðu barkarennur eða miðbláæðaleggi,
hlutu meðferð með H,-hemlum eða höfðu
hjarta- og lungnasjúkdóma fyrir. Ekki var