Szpitalne zapalenie płuc u chorych operowanych. Analiza wyników systemu czynnej rejestracji zakażeń szpitalnych Polskiego Towarzystwa Zakażeń Szpitalnych*

*Jadwiga Wójkowska-Mach, Anna Różańska, Małgorzata Bulanda, Piotr B. Heczko

Summary
Background.Despite significant advances in perioperative care, nosocomial infection remains a major cause of morbidity and mortality in surgical patients.
Methods. The purpose of the study was to analyze the epidemiology and etiology of hospital-acquired pneumonia (PNEU) in surgical patients. Data were collected from 33 adult regional hospitals using unified questionnaires. Infection criteria were based on the Centers for Disease Control and Prevention (CDC) recommendations, and detailed analysis was conducted in NNIS defined categories of surgical procedures.
Results. 283 PNEU cases were detected among 58, 626 surgical patients. 63% of PNEU patients were treated in intensive therapy units, 84% requiring mechanical ventilation. The rate of PNEU morbidity among surgical patients was 0.5%. The mortality among PNEU patients was 11%, the highest rates being noted after colon and respiratory system surgery. Dominant pathogens were Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus. We did not detect prevalence of any particular type of bacteria in relation to the category of surgical procedure. Cultures were taken from only 17% of PNEU patients who did not require mechanical ventilation.
Conclusions. We detected a correlation between morbidity caused by nosocomial pneumonia and the type of surgical procedure, however PNEU was not related to preoperative condition or anaesthetic risk. In the majority of PNEU mechanically ventilated patients, the presence of pathogens was confirmed microbiologically.

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