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Identifier |
000415137 |
Title |
Μελέτη επίπτωσης λοιμώξεων που συνδέονται με παροχή υπηρεσιών υγείας στην μονάδα εντατικής θεραπείας του Γ.Ν. Ρόδου |
Alternative Title |
Surveillance of healthcare-associated infections in the intensive care unit of general hospital of Rhodes |
Author
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Πάχου, Μαρία
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Thesis advisor
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Μπριασούλης, Γεώργιος
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Reviewer
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Γκίκας, Αχιλλέας
Γεωργόπουλος, Δημήτριος
Ηλία, Σταυρούλα
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Abstract |
Background: Infections related to health care or hospital infections
(HAIs) tend to be a serious risk factor for patients as they contribute
significantly to increasing their morbidity and mortality rates and
multiplying the cost of hospitalization. The increased incidence of HAI in
ICU patients demands a systematic surveillance and an immediate
implementation of measures for their prevention and control. The
present study of HAI incidence in the intensive care unit of General
Hospital of Rhodes based on the European Centre for Disease Prevention
and Control (ECDC) EUROPEAN SURVEILLANCE OF HEALTHCAREASSOCIATED
INFECTIONS IN INTENSIVE CARE UNITS protocol focuses
on these axes. The purpose of the study is to: 1) apply surveillance to the
General District Hospital of Rhodes in order to gain experience in the
implementation of the ECDC protocols 2) evaluate the instructions for
recording, data collection and familiarization with the recording
protocols, analyzing the results and drawing conclusions; 3) identify the
problems of HAI and finally designing interventions to solve them. This
study will also be the basis for the implementation of national-level
records.
Methodology: The study was conducted at the Adult Intensive Care Unit
of General Hospital of Rhodes for six consecutive months. The ECDC
protocol HAI ICU Protocol v2.2 was used. Surveillance was performed for
all ICU patients stayed more than two days until discharge from the unit.
Three classes of HAI, pneumonia (PN), bacteremia (BSI) and urinary tract
infections (UTI) and their association with relevant devices (respiratory
devices, central intravascular catheters, urine catheters) were studied.
The frequencies of pathogens identified as causative agents of HAI
growth in ICU Rhodes were recorded, as well as their resistance.
Antibiotic stewardship was also performed for the surveillance time
period.
ΦΕΒΡΟΥΑΡΙΟΣ
2018
[ΠΡΟΓΡΑΜΜΑ ΜΕΤΑΠΤΥΧΙΑΚΩΝ ΣΠΟΥΔΩΝ
ΕΠΕΙΓΟΥΣΑ ΚΑΙ ΕΝΤΑΤΙΚΗ ΘΕΡΑΠΕΙΑ ΠΑΙΔΩΝ ΚΑΙ ΕΦΗΒΩΝ]
15
Results: 52.9% of the HAI recorded were blood stream infections (BSI),
23.5% were catheter-related BSI (CR-BSI), 11.8% were catheterassociated
urinary tract infections and 11.8% intubation devices related
pneumonia episodes. The incidence rate was 2.44 episodes of pneumonia
per 1000 intubation days, 9,5 episodes of BSIs per 1000 patient days,
4.22 CR-BSIs per 1000 central venous catheter days and 2.1 urinary
infections per 1000 urine catheter days. The gross mortality was 39.3%.
The most frequent identified pathogens were: Acinetobacter baumanii
(17.6%) Klebsiella pneumoniae (58.8%) and Pseudomonas aeruginosa
(17.6%) with carbapenemes resistance 100%, 67%, and 67%
respectively. Of the antibiotics used, 14.3% was used as causative
therapy, 85.1 %% as empirical therapy and 0.6 % as pharmaceutical
prophylaxis. The most frequently used antibiotic groups were:
carbapenemes (17.5%), β-lactamase inhibitors (7.1%), cephalosporins
(11%), quinolones (5.2%) and colistin (10.7%).
Conclusions: This study demonstrates that an actual incidence of HAIrelated
devices cannot be substantiated. HAI prolong the ICU length of
stay but are not independently related to mortality. In our single-center
series, HAIs are associated with high rates of multivalent pathogens
Klebsiella and Acinetobacter and an extensive use of empirical antibiotic
treatment. Prevention measures, continued surveillance, and
implementation of bundles are urgently needed
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Language |
Greek |
Subject |
Antibiotic resistance |
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Bloodstrem infection |
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ΜΕΘ |
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Μικροβιαιμία |
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Μικροβιακή αντοχή |
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Νοσοκομειακές λοιμώξεις |
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Ουρολοίμωξη |
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Πνευμονία |
Issue date |
2018-03-28 |
Collection
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School/Department--School of Medicine--Department of Medicine--Post-graduate theses
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Type of Work--Post-graduate theses
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Permanent Link |
https://elocus.lib.uoc.gr//dlib/4/0/5/metadata-dlib-1524063485-157031-29702.tkl
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Views |
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