ارتباط میان مصرف پروفیلاکسی آنتی بیوتیکی قبل از جراحی و عفونت‌های بیمارستانی در بخش مراقبتهای ویژه (ICU)

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه فیزیولوژی و فارماکولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی کردستان

2 دانشگاه شیراز، دانشکده دامپزشکی، بخش علوم پایه، شیراز، ایران

3 گروه ایمنی شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی شهرکرد

4 گروه عفونی، دانشکده پزشکی، دانشگاه تهران، تهران، ایران

چکیده

زمینه و هدف: عفونت‌های بیمارستانی (Nosocomial infections یا NIs) در زمان بستری در بخش مراقبتهای ویژه ممکن است باعث ایجاد عوارض، مرگ و میر و بستری شدن مجدد در بیمارستان شود. هدف از انجام این مطالعه تعیین فاکتورهای خطر در عفونت‌های بیمارستانی در بخش مراقبتهای ویژه با تأکید بر مصرف پروفیلاکسی آنتی بیوتیک قبل از اعمال جراحی است.
مواد و روش ها: یک مطالعه گذشته نگر درمورد NIs در بخش مراقبتهای ویژه در فاصله زمانی اکتبر 2019 تا می 2020 در یک بیمارستان دولتی در تهران انجام شد. میزان کلی عفونت، محل ایجاد عفونت، پاتوژن بیماری زا، مدت زمان بستری در ICU و فاکتورهای خطر برای عفونت‌های بیمارستانی مورد ارزیابی قرار گرفتند.
یافته ها: میزان NIs در بیمارانی که از یک آنتی بیوتیک قبل از جراحی استفاده کرده بودند در مقایسه با بیمارانی که بیش از یک آنتی بیوتیک دریافت کرده بودند؛ به طور معنی داری کمتر بود (p <0.001). استفاده طولانی مدت از آنتی‌بیوتیک‌ها به‌منظور پروفیلاکسی قبل از جراحی و یا استفاده از آنتی‌ بیوتیک های وسیع الطیف ریسک عفونت‌های بیمارستانی در ICU را افزایش داد.
نتیجه گیری: نتایج نشان داد که استفاده بیش از یک آنتی بیوتیک به‌عنوان پروفیلاکسی قبل از جراحی با ریسک بالای عفونت‌های بیمارستانی مرتبط است. علاوه بر این، تجویز آنتی‌بیوتیک‌های وسیع الطیف به‌عنوان پروفیلاکسی قبل از جراحی و همچنین استفاده طولانی مدت از تجهیزات پزشکی، با خطر ابتلا به NIs را در بیماران بدحال ارتباط دارد.

کلیدواژه‌ها

عنوان مقاله [English]

Relationship between surgical antibiotic prophylaxis and nosocomial infection in intensive care units

نویسندگان [English]

  • Ehsan Motaghi 1
  • Razieh Gerami 2
  • Masumeh Ghasemi 3
  • Shahin Jafarpour 4
  • Mohammad Javad Hosseini 4
1 Department of Physiology and Pharmacology, School of Medicine, Kurdistan University of Medical Sciences.
2 Shiraz University, Collage of veterinary, Basic Science Section
3 Immunology Department,, School of Medicine, Shahrekord University of Medical Science
4 Department of Infectious disease, School of Medicine, Tehran University, Tehran, Iran
چکیده [English]

Background and aim: Nosocomial infections (NIs) during ICU admission may cause morbidity, mortality and hospital readmissions. The aim of this study was to determine risk factors of nosocomial infections in ICUs with an emphasis on preoperative antibiotic prophylaxis.
Method: A retrospective study of NIs was conducted in ICUs of a public hospital in Iran between October 2019 and May 2020. The overall rate of NI, distribution of the infection sites and responsible pathogen and the length of ICU stay as well as the risk factors of NIs were investigated.
Results: The rate of NIs in patients receiving one preoperative antibiotic was much lower than that in patients receiving more than one antibiotics (p<0.001). Long-term pre-operative antibiotic prophylaxis or use of broad spectrum surgical prophylaxis increased the risk of NIs in ICUs.
Conclusions: The results indicated that using of more than one antibiotic as preoperative prophylaxis is associated with higher risk of NIs. Moreover, administration of broad spectrum antibiotics as preoperative prophylaxis increase the risk of NIs in critically ill patients.

کلیدواژه‌ها [English]

  • Acinetobacter
  • Nosocomial infections
  • infection inhibition

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 65، شماره 3
مرداد-شهریور1401
مرداد و شهریور 1401
صفحه 904-911

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