RESUMO
OBJECTIVE: To understand the situation of the device-associated infection (DAI) in the medical-surgical intensive care unit(ICU)inpatients in an A-level tertiary class hospital in Beijing. METHODS: DAI date were collected through a surveillance on the medical-surgical ICU inpatients in an A-level tertiary class hospital in Beijing from January 2008 to December 2010. RESULTS: In 2279 patients admitted to the medical-surgical ICU (with a 15,332 days total hospitalization stay), 283 were found infected. The incidence for in-hospital infection was 12.42%, and 2.452% for the incidence per patient-day. The device utilization ratios for ventilator, central venous catheter and urinary catheter were 56.76%, 59.01% and 80.07% respectively while the incidence for ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) were 1.632%, 0.409% and 0.350% respectively. The predominant bacteria species found in these cases were Gram-negatives and the main stay of pathogenic species were A. baumannii, P. aeruginosa, Staphylococcus, E. coli, K. pneumoniae and C. albicans etc. CONCLUSION: The incidence of DAI in the surveyed hospital is close to other hospitals in China and other developing countries but higher than hospitals in United States. More efforts should be made for its prevention / control by hospital stuff, with the cooperation from the patients.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Equipamentos e Provisões/efeitos adversos , Pacientes Internados , Cateterismo Venoso Central/efeitos adversos , Cateteres de Demora/efeitos adversos , Cateteres de Demora/microbiologia , China , Contaminação de Equipamentos , Equipamentos e Provisões/microbiologia , Humanos , Incidência , Unidades de Terapia Intensiva , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Respiração Artificial/efeitos adversos , Infecções Urinárias/epidemiologia , Infecções Urinárias/prevenção & controleRESUMO
Gestational hyperlipidemic pancreatitis is an uncommon complication of pregnancy that incurs a high risk of morbidity and mortality of both maternal and fetal patients. We described the response of continous renal replacement therapy in a woman with extreme gestational hyperlipidemia and severe pancreatitis. Five consecutive plasma exchanges didn't lead to a remarkable reduction (10.4% and 4.8%, for the first and fourth times, respectively) at triglyceride levels as the literatures have reported, which reveals that plasma exchange and continous veno-venous heamofiltration may be importment, instead of crucial methods in dealing with gestational hyperlipidemic pancreatitis.