| Summary: | 碩士 === 國立臺灣大學 === 公共衛生碩士學位學程 === 99 === Purpose
The purpose of this thesis is to describe the trends of incidence of healthcare-associated urinary tract infection (HA-UTI) and catheter-associated urinary tract infection(CA-UTI) in adult intensive care units (ICUs ) at National Taiwan University Hospital, from 2002 to 2010. In addition, time series analysis was used to investigate the impacts of various infection control programs on the incidences of HA-UTI and CA-UTI in adult ICUs.
Method
This is a retrospective study. The study population was patients developing HA-UTI, includind CA-UTI while staying in adult ICUs at NTUH from 2002 to 2010. To identified the independent factors associated with HA-UTI and/or CA-UTI, environmental factors (catheter utilization, severe acute respiratory syndrome, seasonal effects), and infection control interventions (hand hygiene, the project of reducing catheter- associated urinary tract infection, Bundle care) were treated as independent variables; incidence densities of HA-UTI and CA-UTI were treated as the dependent variable. Time series analysis using Poisson regression model was used to evaluate the potential effects of independent variables on dependent variable. A p value less than 0.05 were considered as statistically significantly.
Result
Because the baselin incidence rates of HA-UTI and CA-UTI were different in surgical and medical ICU, and also the infection control interventions as well as the adherence of healthcare workers to these interventons, the impact of the results are different. Since April 2004, hand hygiene campaign were implemented. It reduced the HA-UTI and CA-UTI significantly (p< 0.0183). For adult surgical intensive care unit, promotion of the "Bundle care" intervention reduced the HA-UTI and CA-UTI significantly (p< 0.002) . Both HA-UTI and CA-UTI decrease in adult medical and surgical ICUs with time.
Conclusion
This study showed that the impact of various projects on reducing CA-UTI is significant, In addition, self-improvement project and infection control interventions were also helpful for decreasing HA-UTI and CA-UTI.
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