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首页> 外文期刊>International Journal of Infection Control >Healthcare associated infections by multidrug resistant in pediatric intensive care: Analysis of four years.
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Healthcare associated infections by multidrug resistant in pediatric intensive care: Analysis of four years.

机译：儿科重症监护室中多药耐药的医疗保健相关感染：四年分析。

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Objective: To report healthcare associated infections (HAI) in intensive care units of children, caused by multidrug resistant bacteria, and measures to control them. Methods: a retrospective descriptive study of all HAI in three pediatric intensive care units and one neonatal intensive care unit of Prontobaby Hospital da Crian?a, Rio de Janeiro, Brazil. Results: Between 2009 and 2012 we had 36,883 patients-days which 10,442 were from NICU and 26,441 from the PICUs. We reported 482 healthcare-related infections (109 from NICU and 373 from PICU). Gram negative bacteria were the most prevalent group, also in NICU (22.9%) as in PICU (35.9%). The rates of multiresistant Gram positive bacteria (MRSA and CoNS multiresistant) of HAI in the PICUs and NICU were 22% (22/100) and 13,6% (3/22) respectively. The rates of multiresistant Gram negative bacteria (ESBL group, P.aeruginosa resistant to carbapenem, Acinetobacter sp multiresistant, B.cepaciae and S. maltophilia) in PICUs and NICU were 49,3% (66/134) and 56% (14/25) respectively. Ventilator-associated pneumonia was the most common type of infection (incidence density rate of 7,0 per 1000 VM-days) in PICU. A bundle of measures (training of team assistance, oral chlorexidine to all intubated children and use of bacteriological filters in expiration phase) was implemented in the two last years of study and reduced the number of VAP to 2,2 per 1000 VM-days. Conclusion: We found higher rates of multiresistant Gram negative bacteria also in PICU as NICU and a bundle of measures to control VAP in PICU was a well done intervention.
机译：目的：报告由多药耐药菌引起的儿童重症监护病房的医疗保健相关感染（HAI）及其控制措施。方法：对巴西里约热内卢Protobaby Hospital da Crian？a的三个儿科重症监护病房和一个新生儿重症监护病房的全部HAI进行回顾性描述性研究。结果：2009年至2012年，我们共有36,883名患者-日，其中10,442名来自重症监护病房，26,441名来自重症监护病房。我们报告了482例与医疗保健相关的感染（109例来自NICU，373例来自PICU）。革兰氏阴性菌是最常见的细菌，在重症监护病房（22.9％）中，在重症监护病房（35.9％）中也是如此。 PICU和NICU中HAI的多重耐药革兰氏阳性菌（MRSA和CoNS多重耐药）的发生率分别为22％（22/100）和13.6％（3/22）。在重症监护病房和重症监护病房中，多重耐药革兰氏阴性菌（ESBL组，对碳青霉烯耐药的铜绿假单胞菌，多重耐药不动杆菌，头孢杆菌和嗜麦芽糖链球菌）的发生率分别为49,3％（66/134）和56％（14 / 25）。呼吸机相关性肺炎是PICU中最常见的感染类型（每1000 VM日发生率为7.0）。在最近两年的研究中，采取了一系列措施（培训团队协助，对所有插管儿童口服氯西定和在呼气阶段使用细菌过滤器），并将VAP的数量减少至每1000 VM天2.2。结论：我们发现，PICU中的多重耐药革兰氏阴性菌发生率也更高，因为重症监护病房（NICU）和一系列控制PICU中VAP的措施是一项完善的干预措施。

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