The prevalence of and risk factors for healthcare-associated infections in Slovenia: results of the second national survey
| Autor: | Mojca Serdt, Božena Kotnik Kevorkijan, Jana Kolman, Irena Klavs, Tatjana Lejko Zupanc, Aleš Korošec |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Healthcare associated infections Point prevalence survey medicine.medical_specialty Pediatrics animal structures Multivariate analysis prevalence 030106 microbiology raziskava slovenija okužbe 03 medical and health sciences 0302 clinical medicine Intensive care risk factors Medicine survey prevalenca 030212 general & internal medicine slovenia povezane z zdravstvom business.industry Public health Public Health Environmental and Occupational Health virus diseases Odds ratio Confidence interval presečna Antimicrobial use healthcare-associated infections Emergency medicine Public aspects of medicine RA1-1270 business dejavniki tveganja Research Article |
| Zdroj: | Slovenian Journal of Public Health, Vol 55, Iss 4, Pp 239-247 (2016) Slovenian Journal of Public Health |
| ISSN: | 1854-2476 |
| DOI: | 10.1515/sjph-2016-0033 |
| Popis: | In the second Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute-care hospitals, we estimated the prevalence of all types of HAIs and identified risk factors.Patients from acute-care hospitals were enrolled into a one-day cross-sectional study in October 2011. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors.Among 5628 patients, 3.8% had at least one HAI and additional 2.6% were still being treated for HAIs on the day of the survey; the prevalence of HAIs was 6.4%. The prevalence of urinary tract infections was the highest (1.4%), followed by pneumoniae (1.3%) and surgical site infections (1.2%). In intensive care units (ICUs), the prevalence of patients with at least one HAI was 35.7%. Risk factors for HAIs included central vascular catheter (adjusted odds ratio (aOR) 4.0; 95% confidence intervals (CI): 2.9-5.7), peripheral vascular catheter (aOR 2.0; 95% CI: 1.5-2.6), intubation (aOR 2.3; 95% CI: 1.4-3.5) and rapidly fatal underlying condition (aOR 2.1; 95% CI: 1.4-3.3).The prevalence of HAIs in Slovenian acute-care hospitals in 2011 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.Druga slovenska nacionalna presečna raziskava bolnišničnih okužb (BO) je potekala v okviru evropske presečne raziskave okužb, povezanih z zdravstvom, in uporabe protimikrobnih zdravil v bolnišnicah za akutno oskrbo. Naši cilji so bili oceniti prevalenco vseh vrst BO in opredeliti dejavnike tveganja za BO.V enodnevno presečno raziskavo smo vključili vse bolnike, ki so bili na izbrani dan v oktobru 2011 zdravljeni v slovenskih bolnišnicah za akutno oskrbo. Z deskriptivnimi analizami smo opisali značilnosti bolnikov, izpostavljenost invazivnim posegom in ocenili prevalenco različnih vrst BO. Z univariatnimi in multivariatnimi analizami povezanosti BO z možnimi dejavniki tveganja smo opredelili dejavnike tveganja.Na dan raziskave je imelo BO 3,8% (95-odstotni interval zaupanja: 3,3%–4,4%) bolnikov in dodatnih 2,6% (95-odstotni interval zaupanja: 2,1%–3,0%) bolnikov je bilo še vedno zdravljenih zaradi BO, torej je imelo BO 6,4% (95-odstotni interval zaupanja: 5,7%–7,0%) bolnikov oziroma je bila prevalenca BO 6,4%. Na 100 bolnikov je bilo 7,0 epizod BO, ker so nekateri bolniki imeli več kot eno epizodo. Najvišja je bila prevalenca okužb sečil (1,4%), sledile so pljučnice (1,3%) in okužbe kirurških ran (1,2%). Delež bolnikov z vsaj eno BO je bil najvišji v enotah za intenzivno zdravljenje (35,7%). Na 100 bolnikov v enotah za intenzivno zdravljenje je bilo 42,5 epizod BO. V primerjavi z bolniki brez različnih invazivnih posegov so imeli bolniki s centralnim žilnim katetrom 4,0-krat višji obet za nastanek BO (prilagojeno razmerje obetov (pRO) 4,0; 95-odstotni interval zaupanja: 2,9–5,7), bolniki s perifernim žilnim katetrom 2,0-krat višji obet za nastanek BO (pRO 2,0; 95-odstotni interval zaupanja: 1,5–2,6), intubirani bolniki 2,3-krat višji obet za nastanek BO (pRO 2,3; 95-odstotni interval zaupanja: 1,4–3,5) in bolniki s hitro smrtno boleznijo 2,1-krat višji obet za nastanek BO (pRO 2,1; 95-odstotni interval zaupanja: 1,4–3,3).Prevalenca BO v slovenskih bolnišnicah za akutno oskrbo je bila v letu 2011 precejšnja. Predvsem je bila visoka v enotah za intenzivno zdravljenje. Preprečevanje in obvladovanje BO je pomembna javnozdravstvena prednostna naloga. Za preprečevanje in obvladovanje BO, ki temelji na dokazih, je treba vzpostaviti nacionalno epidemiološko spremljanje BO tudi v enotah za intenzivno zdravljenje. |
| Databáze: | OpenAIRE |
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