Diabetes and Hemoglobin A1c as Risk Factors for Nosocomial Infections in Critically Ill Patients
نویسندگان
چکیده
UNLABELLED Objective. To evaluate whether diabetes mellitus (DM) and hemoglobin A1c (HbA1c) are risk factors for ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) in critically ill patients. Methods. Prospective observational study; patients were recruited from the intensive care unit (ICU) of a general district hospital between 2010 and 2012. INCLUSION CRITERIA ICU hospitalization >72 hours and mechanical ventilation >48 hours. HbA1c was calculated for all participants. DM, HbA1c, and other clinical and laboratory parameters were assessed as risk factors for VAP or BSI in ICU. Results. The overall ICU incidence of VAP and BSI was 26% and 30%, respectively. Enteral feeding OR (95%CI) 6.20 (1.91-20.17; P = 0.002) and blood transfusion 3.33 (1.23-9.02; P = 0.018) were independent risk factors for VAP. BSI in ICU (P = 0.044) and ICU mortality (P = 0.038) were significantly increased in diabetics. Independent risk factors for BSI in ICU included BSI on admission 2.45 (1.14-5.29; P = 0.022) and stroke on admission2.77 (1.12-6.88; P = 0.029). Sepsis 3.34 (1.47-7.58; P = 0.004) and parenteral feeding 6.29 (1.59-24.83; P = 0.009) were independently associated with ICU mortality. HbA1c ≥ 8.1% presented a significant diagnostic performance in diagnosing repeated BSI in ICU. Conclusion. DM and HbA1c were not associated with increased VAP or BSI frequency. HbA1c was associated with repeated BSI episodes in the ICU.
منابع مشابه
Risk factors for nosocomial pneumonia in critically ill trauma patients.
Nosocomial pneumonia is the most common pulmonary complication in trauma patients and the leading cause of death in nosocomial infections. A comprehensive review of pneumonia studies is provided. The Centers for Disease Control's nosocomial pneumonia pathogenesis model is reviewed and was used to guide the selection of risk factors evaluated in this study. The purposes of this research were to ...
متن کاملNosocomial Infection in Critically Ill Patient Receiving Stress Ulcer Prophylactic Drugs
Acidic pH of stomach, which is a normal physiological barrier against bacterial overgrowth, would increase by stress ulcer prophylaxis initiation and may lead to bacterial colonization and play as a source for infection transmission to the respiratory system which results in ventilator related pneumonia in patients admitted to the Intensive Care Units (ICUs). Therefore, finding methods to ...
متن کاملعوامل خطر ساز ابتلا به زخم فشاری در بیماران دارای ضایعه مغزی - نخاعی بستری در منزل
Background: Critically ill brain-spinal cord injured patients are at high risk for pressure ulcers. The aim of this study was to investigate risk factors of developing pressure ulcers in critically ill patients with brain-spinal cord injuries. Methods: This cross-sectional study was conducted on 62 home care patients with brain-spinal cord injuries in Hamadan city in 2012. For three weeks, ev...
متن کاملManagement of Candiduria: Grey Zones Still Exist
Critically ill patients are a susceptible group for opportunistic Candida infections. The major risk factors identified with candiduria are extremes of age, female sex, diabetes mellitus, use of immunosuppressive agents, interruption of the flow of urine, radiation therapy, and so on. However, in nosocomial settings, the major risk factors are the use of urinary catheters and the prior use of b...
متن کاملEvaluation of nosocomial infections and risk factors in critically ill patients
BACKGROUND Nosocomial infections are one of the most serious complications in intensive care unit patients because they lead to high morbidity, mortality, length of stay and cost. The aim of this study was to determine the nosocomial infections, risk factors, pathogens and the antimicrobial susceptibilities of them in intensive care unit of a university hospital. MATERIAL/METHODS The patients...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013