بررسی فراوانی عفونت مرتبط با کاتتر ورید مرکزی و نوع پاتوژن و عوامل مرتبط با آن در بخش‌های مراقبت ویژه بیمارستان آیت الله کاشانی اصفهان

نوع مقاله : Original Article(s)

نویسندگان

1 دانشیار بیهوشی، گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استاد گروه بیهوشی، دانشکده پزشکی، مرکز تحقیقات بیهوشی و مراقبت‌های ویژه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشکده پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

10.48305/jims.v43.i829.1050

چکیده

مقاله پژوهشی




مقدمه: با توجه به میزان مرگ و میر و هزینه‌ی مراقبت‌های مرتبط با عفونت ناشی از کاتتر و بستری شدن در بیمارستان، مطالعه باعنوان فراوانی عفونت مرتبط با کاتتر ورید مرکزی و نوع پاتوژن و عوامل مرتبط با آن در بخش‌های مراقبت ویژه بیمارستان آیت الله کاشانی اصفهان انجام شد.
روش‌ها: مطالعه به‌صورت مقطعی، به بررسی میزان عفونت ناشی از کاتتر ورید مرکزی در 78 بیمار بستری در بخش مراقبت‌‌‌های ویژه پرداخت. مدت زمان تعبیه کاتتر، مدت زمان بستری در ICU، محل قرارگیری کاتتر، شدت بیماری با استفاده از معیار APACHE II در طول جاگذاری کاتتر، نوع آنتی‌بیوتیک مصرفی در سال 1399-1400 پرداخت. داده‌ها با آزمون Chi-square با خطای 0/05 تحلیل شد.
یافته‌ها: کمتر از نیمی از بیماران (44/9 درصد) عفونت کاتتر ورید مرکزی را نشان دادند. بیش از نیمی از بیماران دارای پاتوژن گرم مثبت (52/6 درصد) و بقیه دارای پاتوژن گرم منفی بودند. اختلاف معنی‌داری بین جنس، سن و زمان بستری، بیماران و بروز عفونت کاتتر ورید مرکزی مشاهده گردید (0/05 > P). اختلاف معنی‌داری بین بیماری‌های زمینه‌ای، شدت بیماری با استفاده از معیار APACHE II و نوع آنتی‌بیوتیک مصرفی با CRI در بیماران مشاهده نشد. بین فراوانی CRI برحسب محل قرارگیری (فمورال، ژوگولار، ساب کلاوین) در بیماران با کاتتر ورید مرکزی بستری شده در ICU تفاوت معنی‌دار (0/05 > P) و بیشترین میزان عفونت کاتتر ورید مرکزی مربوط به محل قرارگیری ساب کلاوین (51/4 درصد) بود.
نتیجه‌گیری: عدم رعایت بهداشت توسط کادر درمانی، مهم‌ترین عامل در بروز عفونت ناشی از کاتتر ورید مرکزی است. بهترین محل قرارگیری کاتتر، ژوگولار و فمورال بود.

تازه های تحقیق

سید تقی هاشمی: Google Scholar 

بابک علی کیائی: Google Scholar 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Prevalence of Infection Associated with Central Venous Catheter and the Type of Pathogen and Its Related Factors in the Intensive Care Units of Ayatollah Kashani Hospital in Isfahan

نویسندگان [English]

  • Seyed Taghi Hashemi 1
  • Babak Ali Kiai 2
  • Dorin Maghsoudloo 3
1 Associate Professor of Anesthesiology, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Professor of Anesthesiology, School of Medicine, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Given the mortality rate and the cost of care associated with catheter-related infections and hospitalization, this study was conducted to investigate the prevalence of central venous catheter-related infection, the type of pathogen, and its related factors in the Intensive Care Units (ICUs) of Ayatollah Kashani Hospital in Isfahan.
Methods: In this cross-sectional study, 78 patients admitted to the ICU were evaluated for central venous catheter-related infections. Catheter implantation time, ICU length of stay, catheter location, disease severity (assessed using APACHE II criteria during catheter placement), and the type of antibiotic used were evaluated. After collecting data, a Chi-square test and frequency distribution table with related graphs were generated at an error level of 0.05 using SPSS software version 26.
Findings: Less than half of the patients (44.9%) showed central venous catheter infection. Also, more than half of the patients had gram-positive pathogens (52.6%) and the rest had gram-negative pathogens. There was a significant difference between gender, age and time of hospitalization, patients and the incidence of central venous catheter infection (P < 0.05). There was no significant difference between underlying diseases, disease severity using APACHE II criterion and type of antibiotic used with CRI in patients (P > 0.05). Frequency of CRI by location (femoral, jugular, subclavian) was observed in patients with central venous catheter admitted to ICU (P < 0.05) and the highest rate of central venous catheter infection was related to subclavian location (51.4%).
Conclusion: Lack of hygiene by medical staff is the most important factor in the incidence of infection caused by central venous catheter. Factors such as underlying disease, disease severity, and type of antibiotic used do not affect central venous catheter infection. The best location is the catheter, jugular and femoral.

کلیدواژه‌ها [English]

  • Infection
  • Central venous catheter
  • Pathogen type

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مجله دانشکده پزشکی اصفهان
دوره 43، شماره 829
هفته 1، آبان
مهر و آبان 1404
صفحه 1050-1057

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سابقه مقاله

  • تاریخ دریافت: 29 فروردین 1404
  • تاریخ پذیرش: 21 تیر 1404

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