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166257

ENVIRONMENTAL RISK FACTORS OF NOSOCOMIAL INFECTIONS IN NEUROLOGICAL INTENSIVE CARE UNIT

Article

Last updated: 22 Jan 2023

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-

Tags

Medicine

Abstract

Background: The Centers of Disease Control and Prevention (CDC) estimate that 2 million patients develop hospital-acquired infection annually and as many as 88,000 die as a result, adding an estimated $5 billion to the annual national health care costs. Object:  To evaluate risk factors and methods of infection control in surgical site infections in postoperative neurosurgical patients.
Methods:  This study was prospective, uncontrolled and observational study conducted on patients with postoperative neurosurgical operation and admitted to Intensive Care Unit postoperatively.  The study was done in
Al-Azhar university hospitals from March 2017 to March 2018. The study aim was. Analysis of data was done by IBM computer using SPSS (statistical program for social science version 25).
Results:  In the study sample, the mean age and standard deviation (SD) were 42.5 years ±19.1. Female patients were about 40%. Most male patient were above median age of the sample (37.8 years). The overall admission period includes pre-ICU admission, ICU admission and post-ICU admission. The mean and standard deviation of overall admission was 43.7 day±5.5. From the whole study sample, nosocomial infection was estimated to be 88.4% of cases (69 patients). Postoperative mortality among cases was 36%. The rest of cases were either referred or discharged to ward. Comorbid conditions may present as single factor or multiple factors in the same patient. Patients with nosocomial infections were found to have two or more comorbid conditions while infection-free cases were found to have no or at least one factor in a statistically significant association. It has been found that most cases with traumatic brain injury and hemorrhagic stroke had nosocomial infection (74%). Both types mentioned previously had longer ICU stay.  It has been found that nosocomial infection is commonly predominant in traumatic brain injury and intracranial hemorrhage cases (ICH). 
Nosocomial infections were found to be either single or multiple infections in the same person. Most of infections were; respiratory tract infection, urinary tract infection or septicemia. When the entire study sample was subjected to logistic regression analysis, age, diagnosis and hospital stay, necessity for ventilation, low Glasgow Coma Scale (GCS), high temperature, high humidity and low karnofsky were found to be significantly independently predictive of postoperative nosocomial infection. Among these patients, type and timing of operative intervention and environmental factors did not significantly affect outcome.
Conclusion:  There are many risk factors of nosocomial infection in hospitalized neurosurgical treated, which requires strict monitor, including the development of various effective prevention measures and check of their implementation as well as effectiveness, to reduce the incidence of hospital infection.

DOI

10.21608/jes.2020.166257

Keywords

Nosocomial infection, Environmental factors

Authors

First Name

Shrief

Last Name

Salah El Deen

MiddleName

M.

Affiliation

Post Grad. Student Institute of Environmental Studies and Research Ain shams University

Email

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City

-

Orcid

-

First Name

Mahmoud

Last Name

Elbokhary

MiddleName

S.

Affiliation

Institute of Environmental Studies and Research Ain shams University

Email

-

City

-

Orcid

-

First Name

Hwaida

Last Name

Kamal

MiddleName

M.

Affiliation

Faculty of Medicine, Baha University

Email

-

City

-

Orcid

-

Volume

49

Article Issue

12

Related Issue

24205

Issue Date

2020-12-01

Receive Date

2020-12-24

Publish Date

2020-12-24

Page Start

1

Page End

29

Print ISSN

1110-0826

Online ISSN

2636-3178

Link

https://jes.journals.ekb.eg/article_166257.html

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https://jes.journals.ekb.eg/service?article_code=166257

Order

1

Type

Original Article

Type Code

500

Publication Type

Journal

Publication Title

Journal of Environmental Science

Publication Link

https://jes.journals.ekb.eg/

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Details

Type

Article

Created At

22 Jan 2023