일개 병원 중환자실의 병원성 폐렴에 관한 연구

초록

PURPOSE: As a retrospective study by using of medical records, this was to investigate the incidence rate of nosocomial pneumonia and risk factors and to determine the causing agent. METHODS: Subjects were 336 patients during the period from January 2003 through December 2003. Nosocomial pneumonia was defined according to the definition(CDC, 1992).The statistical SPSS was used to analyze data that included chi-square, t-test and multiple logistic regression. RESULTS: The actual number of patients with nosocomial pneumonia turned out to be 42 out of total 336 patients during the survey period. The incidence rate was 125 per 1,000 patients and 16.7 patients per 1,000 patient-days, which is comparable with 217 patients with ventilator-associated pneumonia per 1,000 patients and 34.8 per 1,000 patient-days. The significant risk factors for nosocomial pneumonia were identified as cardiomegaly based on chest radiography (OR=4.93; 95% CI=1.11-21.94), cerebral hemorrhage(OR=6.27; 95% CI=1.63-24.16), cerebral infarction(OR=4.39; 95% CI=1.05-18.40) and the duration of admission (OR=5.57; 95% CI=3.14-9.88). Causing agents of nosocomial pneumonia were Staphylococcus aureus 21.8%, Pseudomonas aeruginosa 17.4% and Acinetobacter baumani 17.4%. Ventilator-associated pneumonia were Acinetobacter baumani 27.5%, Staphylococcus aureus 24.2%, Pseudomonas aeruginosa 13.8%. CONCLUSIONS: The cardiomegaly at admission, diagnosis and duration of admission were considered to enhance the incidence rate of nosocomial pneunoniae. Further studies and intervention actions would be necessary to deal with the nosocomial pneunoniae.

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