Nosocomial Infection in an Intensive Care Unit in a Brazilian University Hospital

Abstract

This prospective study aimed to determine the nosocomial infection (NI) incidence in an Intensive Care Unit (ICU), its association with clinical characteristics and occurrence sites. It was carried out among 1.886 patients admitted in an ICU of a University Hospital, from August 2005 to January 2008. Data analysis was done using Fisher’s test and Relative Risk (RR). There were 383 NIs (20.3%). The infections were in the urinary tract (n=144; 37.6%), pneumonia (n=98; 25.6%), sepsis (n=58; 15.1%), surgical site (n=54; 14.1%) and others (n=29; 7.7%). Hospitalization average was 19.3 days for patients with NI and 20.2 days for those with colonization by resistant microorganisms. The mortality was 39.5% among patients with NI (RR: 4.4; 3.4-5.6). The NI was associated with patients originated from other units of the institution/emergency unit, more than 4 days of hospitalization, community infection, colonized by resistant microorganisms, using invasive procedures and deaths resulting from NI.

Colonização por micro-organismo resistente e infecção relacionada ao cuidar em saúde

“…Despite the similarity between the ER and the intensive care unit, given the patients' profile, clinical condition and use of invasive procedures, it was verified that the mortality rate and its association with HAI was higher in the present study (16) .…”

“…As to the most prevalent infection sites among the emergency room patients, the distribution of these infections per specific site is similar to those described at ICUs, given the patients' severity and, mainly, the invisible profile of these organisms, which has been ascertained as a characteristic ER and ICU patients have in common (16) .…”

“…The risk these infections entail possibly worsened these patients' clinical situation, which may have enhanced complications and even death. This high mortality rate represents difficulties to compare the findings, as mentioned earlier, due to the lack of research at emergency rooms of emergency care units (10,12,16) .…”

“…Besides, according to some publications, colonization by resistant microorganisms is a risk factor associated with HAI (4,6,14,16) . In this study, the use of invasive procedures and colonization by RM were considered risks for the development of HAI in bivariate logistic regression only.…”

Fatores De Risco Dos Diagnósticos De Enfermagem Do Domínio Segurança/Proteção: Revisão Integrativa

“…Concernente a este resultado, outra pesquisa (8) estabeleceu a relação entre tempo de internação com a prevalência de EA, quando 77% da sua amostra desenvolveu infecção após um tempo médio de internação de cinco dias. O tempo de internação prolongado expõe o paciente ao risco de sofrer com incidentes relacionados à assistência, como no caso dos erros de medicação e o surgimento de infecções, úlceras de pressão (UP) e outros (9)(10) .…”