Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 7-8, Pages: 476-480
https://doi.org/10.2298/SARH1108476G
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Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections
Gajović Olgica (Medicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Todorović Zoran (Medicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Mijailović Željko (Medicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Čanović Predrag (Medicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Nešić Ljiljana (Medicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Đorđević Zorana (Medicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Stanojević Marijana (Medicinski fakultet, Kragujevac + Centralna biohemijska laboratorija, Klinički centar „Kragujevac“, Kragujevac)
Lazić Zorica (Medicinski fakultet, Kragujevac + Centar za plućne bolesti, Klinički centar „Kragujevac“, Kragujevac)
Introduction. Pneumonia is the most frequent nosocomial infection in
intensive care units. The reported frequency varies with definition, the type
of hospital or intensive care units and the population of patients. The
incidence ranges from 6.8-27%. Objective. The objective of this study was to
determine the frequency, risk factors and mortality of nosocomial pneumonia
in intensive care patients. Methods. We analyzed retrospectively and
prospectively the collected data of 180 patients with central nervous system
infections who needed to stay in the intensive care unit for more than 48
hours. This study was conducted from 2003 to 2009 at the Clinical Centre of
Kragujevac. Results. During the study period, 54 (30%) patients developed
nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found
that the following risk factors for the development of nosocomial pneumonia
were statistically significant: age, Glasgow Coma Scale (GCS) score <9,
mechanical ventilation, duration of mechanical ventilation, tracheostomy,
presence of nasogastric tube and enteral feeding. The most commonly isolated
pathogens were Klebsiella-Enterobacter spp. (33.3%), Pseudomonas aeruginosa
(24.1%), Acinetobacter spp. (16.6%) and Staphylococcus aureus (25.9%).
Conclusion. Nosocomial pneumonia is the major cause of morbidity and
mortality of patients with central nervous system infections. Patients on
mechanical ventilation are particularly at a high risk. The mortality rate of
patients with nosocomial pneumonia was 54.4% and it was five times higher
than in patients without pneumonia.
Keywords: nosocomial pneumonia, risk factors, central nervous system infections, mortality
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