Læknablaðið - 15.01.1996, Blaðsíða 78

60
LÆKNABLAÐIÐ 1996; 82
Spítalasýkingar á gjörgæsludeild
Landspítalans
Niðurstöður eftir fyrra ár framskyggnrar rannsóknar
Sigurður Magnason11, Karl G. Kristinsson1’2’, Þorsteinn Sv. Stefánsson1’3’, Helga Erlendsdóttir21, Lo-
vísa Baldursdóttir3*, Eydís Davíðsdóttir2’, Sigurður Guðmundsson1,4*
Nosocomial Infcctions in the Intensive Care Unit at
Landspítalinn
Magnason S, Kristinsson KG, Stefánsson ÞS, Er-
lcndsdóttir H, Baldursdóttir L, Davídsdóttir E, Guð-
mundsson S
Læknablaðið 1996; 82: 60-5
Objective: To determine the nosocomial infection
rate, pathogens, colonisation and hospital mortality
in the Intensive Care Unit (ICU) at Landspítalinn,
which is a ten bed, general medical-surgical ICU.
Methods: Patients admitted for more than 48 hours
were included. Surveillance- cultures were perform-
ed on admission and thereafter three times a week
(tracheal aspirate, oropharyngeal swab, gastric aspi-
rate, urine and other specimens as indicated). ICU
infections were defined by the criteria of CDC,
USA. In the first 12 months 140 patients met the
inclusion criteria at 150 admissions. The study is
ongoing.
Results: Eighty-seven ICU-acquired infections were
diagnosed in 48 of the 150 admissions (32%), the
mean age was 58 years (0-87) and 60% were males.
The most common infections were: UTI 27 (31%),
pneumonia 18 (21%), septicemia 15 (17%), wound
infections eight (9%) and tracheitis seven (8%).
Etiologic agents of the 87 infections were E. coli
Frá 1)læknadeild H.Í., 2)sýklafræðideild, 3,svæfinga- og gjör-
gæsludeild og “’lyflækningadeild Landspítalans. Fyrirspurn-
ir, bréfaskipti: Sigurður Guðmundsson lyflækningadeild
Landspítalans, 101 Reykjavík. Netfang: SIGGUDM.@RSP.
IS.
Lykilorð: Gjörgæsludeild, sýkingar, spítalasýkingar.
Hlutaniðurstöður þessarar rannsóknar voru kynntar á þingi
norrænna svæfingalækna í Reykjavík í júní 1995. (23rd
Congress of the Scandinavian Society of Anaesthesiolog-
ists. Reykjavík, lceland, June 12-16, 1995.) Ágrip birtist í:
Acta Anaesthesiologica Scandinavica 1995; 39/Suppl. 105:
(15), Klebsiella sp. (7) and other Enterobacteríacae
(9), Enterococcus sp. (12), Candida sp. (12), S. epi-
dermidis (7), P. aeruginosa (7) and other/unknown
pathogens (l8). Infected patients stayed for a mean
of 15.0 days and uninfected patients 4.2 days
(p<0.05). Every patient staying for more than three
weeks had at least one infection. The mean age of
infected patients was 63 years and of uninfected
patients 56 years (p<0.05). Neither APACHE-II
nor TISS score on admission differed significantly
between the infected and uninfected groups. Mor-
tality in the ICU was 10.4% (5/48) in the infected
group and 19.6% (20/102) in the uninfected group
(p=0.24).
Conclusion: Nosocomial infections in patients ad-
mitted to the ICU were common and associated with
extended stay. Most of the infections were caused by
Gram-negative bacilli.
From Intensive Care Unit, Departments of Medicine
and Clinical Microbiology, Landspítalinn/the National
University Hospital, Reykjavík, Iceland.
Correspondence: Sigurður Guðmundsson, Department
of Medicine, Landspftalinn, the National University
Hospital, 101 Reykjavík, Iceland. E-mail: SIG-
GUDM.@RSP.IS.
Ágrip
Markmið: Að meta tíðni spítalasýkinga og
greina sýkingarvalda, áhættuþætti sýkinga,
sýkingarstaði, bólfestu sýkla og dánartíðni á
gjörgæsludeild Landspítalans, sem er 10 rúma
alntenn gjörgæsludeild.
Aðferðir: I rannsóknina voru teknir sjúk-
lingar sem dvöldu lengur en 48 stundir á deild-
inni. Skimað var fyrir sýklunt með því að taka
ræktanir við innlögn og síðan þrisvar í viku (frá
barka, maga, munnkoki, þvaglegg og öðrum
stöðum eftir þörfum). Sýkingar voru greindar
samkvæmt skilmerkjum frá CDC, Bandaríkj-
unum. Á fyrstu 12 mánuðum rannsóknarinnar
hafa 140 sjúklingar verið teknir inn í rannsókn-