DECREASE OF URINARY TRACT INFECTIONS FOLLOWING CATHETERIZATION AFTER THE EDUCATION OF HEALTH CARE WORKERS, INTRODUCTION OF PROTOCOLS AND SURVEILLANCE LISTS

Autori:

Maja Tomić Paradžik, Božana Levojević, Antonija Gabrić

Sažetak

Sažetak. Infekcije mokraćnog sustava (IMS) kao posljedica kateterizacije pripadaju među najčešće bolničke infekcije, a učestalost im iznosi 30–40% od svih bolničkih infekcija. Velik broj takvih infektivnih epizoda može se prevenirati aktivnom, kontinuiranom edukacijom zdravstvenih radnika, implementacijom jasno vidljivih postupnika o postavljanju i održavanju urinarnih katetera i redovitim praćenjem kateteriziranih bolesnika putem nadzornih lista. Ovim putem želimo upozoriti na važnost navedenih aktivnosti prikazom značajnog smanjenja IMS povezanih s primjenom katetera na Odjelu za urološke bolesti OB u Slavonskom Brodu u dva perioda. Nakon provođenja gore navedenih postupaka, utvrdili smo statistički značajnu razliku u padu incidencije IMS koje prate kateterizaciju, i to s 20,4% na 11,7%, tj. c2=17,5; p<0,01 i posljedično, značajno smanjenje broja bolničkoopskrbnih dana, c2=16,62; p<0,01, dok razlika u ukupnoj potrošnji antibiotika na odjelu, unatoč padu broja IMS, nije bilo. Najčešći uropatogeni, bez značajne razlike u oba perioda bili su E. coli (29,7%), Enterococcus spp (20%) te Pseudomonas aeruginosa (15,8%). Strogo pridržavanje i provođenje preventivnih mjera, kao i nadzor nad njihovim provođenjem važan su činitelj u smanjenju broja bolničkih infekcija.

Summary

Summary. Urinary tract infections (UTI) following catheterization are the most common hospital-acquired infections, with their frequency amounting to 30–40% of all hospital infections. Major percentage of this kind of infectious episodes can be prevented via active and continual education of health care workers (HCW), implementation of transparent protocols concerning installation and attendance of urinary catheters and regular control of catheterized patients through surveillance lists. This research shows the importance of afore-mentioned activities, demonstrating a significant decrease of UTI following catheterization at the Department of Urology in Slavonski Brod General Hospital during two periods. After the afore-mentioned procedures were conducted, a statistically significant discrepancy in the decrease of the UTI incidence following catheterization was identified, from 20.4% to 11.7%, i.e. c2=17.5; p<0.01, and accordingly, significant decrease of the number of hospital bed-days, i.e. c2=16.62; p<0.0, while total consumption of antibiotics at the Department was not reduced, despite the decrease in the number of UTI.The most common uropathogens, with no significant difference in both periods, were E. coli (29.7%), Enterococcus spp (20%), and Pseudomonas aeruginosa (15.8%). Strict implementation and close surveillance of the recommended preventive measures are an important factor in reducing the number of hospital infections.