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Srpski arhiv za celokupno lekarstvo
2011, vol. 139, br. 7-8, str. 476-480
jezik rada: srpski
vrsta rada: originalan članak
doi:10.2298/SARH1108476G


Incidencija, faktori rizika i ishod bolničkih pneumonija kod osoba sa infekcijama centralnog nervnog sistema
aMedicinski fakultet, Kragujevac + Klinika za infektivne bolesti, Klinički centar, Kragujevac
bMedicinski fakultet, Kragujevac + Centralna biohemijska laboratorija, Klinički centar, Kragujevac
cMedicinski fakultet, Kragujevac + Centar za plućne bolesti, Klinički centar, Kragujevac

e-adresa: gaja.kg@open.telekom.rs

Sažetak

Uvod. Bolničke pneumonije su najčešće bolničke infekcije u jedinici intenzivne nege. Učestalost ovih pneumonija je različita (6,8-27%), a zavisi od vrste bolnice, intenzivne jedinice, kao i od samih bolesnika. Cilj rada. Cilj istraživanja je bio da se utvrde učestalost i najznačajniji faktori rizika bolničke pneumonije, te ishod lečenja bolesnika. Metode rada. Retrospektivnom i prospektivnom analizom obuhvaćeno je 180 bolesnika s teškim infekcijama centralnog nervnog sistema (CNS) koji su lečeni u jedinici intenzivne nege najmanje 48 sati u periodu 2003-2009. godine u Kliničkom centru u Kragujevcu. Rezultati. Tokom posmatranog perioda bolničke pneumonije su dijagnostikovane kod 54 bolesnika (30%). One su u proseku nastajale nakon 10±6 dana. Starost bolesnika, poremećaj stanja svesti, skor na Glazgovskoj skali kome (Glasgow Coma Scale) manji od 9, mehanička ventilacija i njeno trajanje, traheotomija, enteralna ishrana i primena nazogastrične sonde bili su statistički značajni faktori rizika za nastanak bolničkih pneumonija. Najčešći uzročnici pneumonija bili su mikroorganizmi: Klebsiella-Enterobacter spp. (33,3%), Pseudomonas aeruginosa (24,1%), Acinetobacter spp. (16,6%) i Staphylococcus aureus (25,9%). Zaključak. Bolničke pneumonije su značajan uzrok morbiditeta i mortaliteta bolesnika s infekcijama CNS. Rizik je posebno visok kod bolesnika na aparatima za veštačko disanje. Smrtnost osoba sa bolničkim pneumonijama bila je 54,4%, što je pet puta veće nego kod bolesnika bez pneumonije.

Ključne reči

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