某區域教學醫院加護病房內個人房與開放式床位之院內感染探討

Surveillance of Healthcare Associated Infections on a Single Room Area and an Open Single-Space Area at Intensive Care Unit

許文祥(Boon-Siang Khor) ； 陳煥昇(Huang-Sheng Chen) ； 許詩典(Shih-Tien Hsu) ； 羅瑞瑜(Jui-Yu Lo) ； 劉孝有(Hsiao-Yu Liu) ； 廖訓禎(Shiumn-Jen Liaw)

《感染控制雜誌》 19卷6期 (2009/12) Pp. 354-361

https://doi.org/10.6526/ICJ.200912_19(6).0002

摘要

加護病房內的硬體設計常與院內感染有關，本研究主要目的在於了解加護病房之個人房與開放式床位在院內感染的差異。研究設計以區域教學醫院加護病房爲基礎之前瞻性調查；研究時間自96年1至12月止，凡住進綜合加護病房個人房(A)區與開放式床位(B)區的病患皆爲研究對象。研究結果顯示，A區院內感染密度平均爲8.7‰；B區10.9‰。A區院內感染率平均爲4.1%，B區6.4%；P值=0.056。A區院內感染部位前三名依序爲血流感染(1.4%)、下呼吸道感染(1.2%)及泌尿道感染(1.0%)；B區爲下呼吸道感染(2.3%)、血流感染(2.0%)及泌尿道感染(1.5%)。A區最常見之感染菌種依序前三名爲綠膿桿茵(16.7%)、金黃色葡萄球菌(12.5%)及黴茵(12.5%)，B區爲金黃色葡萄球菌(24.6%)、綠膿桿菌(12.3%)及黴菌(10.5%)。兩區之院內部位感染及常見菌種發生率比較，均未達統計差異。本研究結論，在不分析病房型態下，加護病房內無論個人房或開放式床位的設計，未顯著影響院內感染率。

關鍵字

加護病房 ； 院內感染 ； 個人房 ； 開放式病床

並列摘要

Interior design of intensive care unit (ICU) has associated with healthcare associated infection. In order to discover the difference in infection rates between a single room area and an open single-space area at ICU, we conducted a hospital-based prospective surveillance study of all patients admitted to a single room area (A) and an open single-space area (B) of the general ICU at a referral teaching hospital in Taoyuan from January 2007 to December 2007. During the study period, the density of healthcare associated infection in areas A and B was 8.7‰ and l0.9‰, respectively. Infection rates of areas A and B were 4.1% and 6.4%, respectively, p value=0.056. The most frequent types of healthcare associated infections in area A were bloodstream infection (1.4%), followed by lower respiratory tract infection (1.2%), and urinary tract infection (1.0%). In area B, the most frequent types of infections were lower respiratory tract infection (2.3%), followed by bloodstream infection (2.0%), and urinary tract infection (1.5%). A total of 81 isolated microorganisms were identified, of them, 24 isolates in area A, and 57 in B. The most frequently pathogens in area A were Pseudomonas aeroginosa (16.7%), followed by Staphylococcus aureus (12.5%) and fungi (12.5%). In area B, the most frequent pathogens were Staphylococcus aureus (24.6%), followed by Pseudomonas aeroginosa (12.3%), and fungi (10.5%). There were no Significant differences in sites of infections as well as causative microorganisms between area A and B. In conclusion, this study suggests that the incidences of healthcare associated infections will be similar either in a single room or an open single-space area in the ICU.

並列關鍵字

Intensive care unit ； healthcare associated infections ； single room ； open single-space area