Analiza uporabe antimikrobnih lijekova i mikrobioloških nalaza kao metoda praćenja prevalencije bolničkih infekcija u kliničkoj bolnici [Analysis use of antimicrobial drugs and microbiology findings as a method for hospital infection prevalence in a clinical hospital]

Bogdanić, Branko (2013) Analiza uporabe antimikrobnih lijekova i mikrobioloških nalaza kao metoda praćenja prevalencije bolničkih infekcija u kliničkoj bolnici [Analysis use of antimicrobial drugs and microbiology findings as a method for hospital infection prevalence in a clinical hospital]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAI) and antimicrobial use, developed by the European Centre for Disease Prevention and Control (ECDC) was used in this analysis. Variables were collected at the University Hospital Centre Zagreb Croatia from 1 July to 13 July 2010. A patient-based protocol was used. Out of 1590 surveyed patients, 10,82% had HAI. The highest prevalence of HAI was observed in intensive care units with 42,88%. Urinary tract infection represented the most common type of HAI and presented 33,72% of all HAI. The most commonly isolated microorganisms were Escherichia coli and Pseudomonas aeruginosa. Application of antimicrobial use in determining the prevalence of HAI is highly sensitive (83,14%) and low specificity (29,8%) method. Application of microbiological findings in determining the prevalence of HAI is low sensitive (59,2%) and low specificity (48,75%), however we must emphasize that the swabs were taken in 75% of cases and were positive in only 59.2%. Application of antimicrobial use and microbiological findings in determining the prevalence of HAI are well sensitive (72,06%) and low specificity (33,67%) methods, but combination of these two methods, significantly contributes the methodology in determining the prevalence of hospital infections and saves time of healthcare workers.

Abstract in Croatian

U ovom istraživanju korištena je standardizirana metodologija Studije prevalencije infekcija u određenom vremenu (Point prevalence survey - PPS), koji je osmišljen od ECDC-a (European Center for Disease prevention and Control) s ciljem procjene infekcije povezane sa zdravstvenom skrbi (Healthcare-associated infections - HAI) i uporabu antimikrobnih lijekova. U razdoblju od 1.srpnja do 13 srpnja 2010.godine provedeno je istraživanje koristeći pilot projekt PPS u Kliničkom bolničkom centru Zagreb. Upotrijebljen je standardizirani upitnik temeljen podacima dobivenih iz povijesti bolesti (patient-based). Obuhvaćeno je 1590 bolesnika, a definiciju HAI zadovoljilo je 10,82% bolesnika. Najveća prevalencija HAI je zabilježena u Jedinicama intenzivnog liječenja s 42,88%. Najčešća HAI je bila infekcija mokraćnog sustava s 33,72%. Najčešće izolirani mikroorganizmi bili su E.coli i Pseudomonas aeruginosa. Primjena antimikrobne terapije u određivanju prevalencije HAI ima dobru osjetljivost (83,14%) i slabu specifičnost (29,8%). Primjena mikrobioloških nalaza u određivanju prevalencije HAI ima slabu osjetljivost (59,2%) i slabu specifičnost (48,75%). Potrebno je naglasiti da su uzorci za mikrobiološku pretragu uzeti u 75% slučajeva, a bili su pozitivni u samo 59,2%. Primjena antimikrobne terapije i mikrobioloških nalaza u određivanju prevalencije HAI ima dobru osjetljivost (72,06%) i slabu specifičnost (33,67%), ali kombinacija ovih dviju metoda značajno doprinosi metodologiji otkrivanja prevalencije bolničkih infekcija uz uštedu vremena zdravstvenih djelatnika.

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