Infekcije urinarnog trakta kod bolesnika sa urinarnim kateterom u hirurškoj jedinici intenzivne nege
Sažetak
Uvod/Cilj. Rizik od infekcije urinarnog trakta je viši kod bolesnika u jedinicama intenzivne nege nego kod ostalih bolesnika zbog toga što oni obično imaju urinarni kateter. Cilj rada bio je da se ispitaju bolesnici sa infekcijom urinarnog trakta povezanom sa kateterom [catheter-associated urinary tract infection (CAUTI)] tokom 6 godina u Hirurškoj jedinici intenzivne nege (HJIN) da bi se utvrdili značajni faktori rizika i uzročnici oboljenja. Metode. Podaci su prikupljeni tokom prospektivnog epidemiološkog nadzora u periodu od 2006. do 2011. godine u HJIN Vojnomedicinske akademije, Beograd, Srbija. Studija slučaja i kontrola je obuhvatila bolesnike sa bolničkim infekcijama zabeleženim tokom epidemiološkog nadzora. Bolesnici sa CAUTI identifikovani su na osnovu definicije Centra za kontrolu i prevenciju bolesti. Kontrolna grupa je obuhvatila bolesnike sa drugim bolničkim infekcijama koji nisu ispunjavali definiciju CAUTI. Rezultati. Epidemiološkim nadzorom obuhvaćeno je 1 369 bolesnika i 13 761 bolničkih dana. Ukupno je zabeleženo 226 bolesnika u HJIN sa bolničkim infekcijama u posmatranom periodu. Među njima, 64 bolesnika imala su CAUTI i 162 su ispunjavala kriterijume za kontrolnu grupu. Multivarijantna logistička regresiona analiza identifikovala je dva faktora rizika nezavisno povezana sa CAUTI: dužina nošenja urinarnog katetera (OR = 1,014; 95% CI 1,005–1,024; p = 0,003) i ženski pol (OR = 2,377; 95% CI 1,278– 4,421; p = 0,006). Izolovan je ukupno 71 patogen iz urinokultura 64 bolesnika sa CAUTI. Candida spp. (28,2%), Pseudomonas aeruginosa (18,3%) i Klebsiella spp. (15,5%) bili su najčesće izolovani mikroorganizmi. Zaključak. Faktori rizika i uzročnici koji su povezani sa nastankom CAUTI u HJIN moraju biti uzeti u obzir pri planiranju mera prevencije CAUTI u ovom okruženju.
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