Professional Documents
Culture Documents
6. ΑΠΟΙΚΙΣΜΟΣ ΑΝΑΠΝΕΥΣΤΉΡΑ
6. ΑΠΟΙΚΙΣΜΟΣ ΑΝΑΠΝΕΥΣΤΉΡΑ
EYZHTHEH
To npoegéxov npóôhnua anó t1ç hoiuógeig otnv AMEO Eivai n mvevuovía. Kópios npoôia-
HeoIKóg napáyovtag eupávionç tns NT eívai n avenápkeia D n napákauyn tav unxaviauáv
águvo tov Siaownnv@LÉv@v appoOTOv.
Znv napoúoa LEAétn n ouxvótnta ng NIT Átav 26%. Napóuoio nodooTÓ (23%) avapépeta
KaI anó tov JIMENER (1989). AviSeta o DU MULIN ET AL. 1982 avapépeI vynió nodootó
oUxvótntaç NT (52%) oe avanveuouKDkeipoupy1KD MEO", H &iapopá autD unopeí va ano-
BoBeí oto eiðos tou HEheróLEVou nAneuouoú Kai otn xpñon öiapopetikáv öiayvaouKúv Le-
9óoov.
H evntótnta tov appúotwv uE NII Átav 40% napóuo1o nodootó (38%) avapépEtai Kai de
ánhes Ehétes*. H Gvntótnta tov aotsváv ue NIT anó Pseudomonas aeruginosa Dtav 70% Kai
33% anó á^hous Gram apvntiKoÚs õakí^hous, avtiêeta otous aoßeveís He NI anó Gram
BeTIKOUS KóKKOUG Áray 4%*. HNNue tnv upndD nç aUxvótnta Kai tnv vyndD tns evntótnta eiva
o onoudaiótepoç auvteteotDçtnç KaGoñiKá_vodOKOLEIaKng Bvntórnta_. Aiápopoinapáyovte
EvOxonoioúvrai yia tnv vyniD avtD êvntótnta, ónwg n napákauyn rov unxaviouáv áuuva_,
n upnAn ouxvórnta tawv Gram apvntikúv 6aKtnpíov oav atioñoy1KOÍ napáyovteg KaI n õapú-
tnta tng unokeíuEvns vóGou. Oi npooeyyíoEIS VIa tn ueíwon tnç Gvntótntaç nç NIT eívai n
npóAnyn tns vóoou KaI n 6£^tíoon tng Gepaneiaç.
H OetiKh ovOxÉtIon HETaßú tng NIT Kai tn_ 81ápketa_ tns unxaviKDç avanvoDs, unopeí va
anoõoteí oe noimoús napáyovteg:
1OpivotpaxeiakÓs Do otouatorpaxeiaKóS OwAÁvaç napakáunteltouSHnxaviouoÜS áuuva_,
entpénei tnv poD tov 6aKtnpíov KaItav EKKpíoewv vúpa anó to Cuff otnv tpaxeia, Kata-
OTpépei to enien^io Kai uEiúvEl tnv ÑaKtnpiCKD Káeapon otnv tpaxeía*
2 2 O1 xELPIOLOÍ nou yivovrai uÉOw toutpaxeioOwAnva. ol oUxvES avappopnoeiç Kai n õpoy
XOOKOnnon KataotpépoUv rnv aKEpaiótnra Kai tn Aeitoupyia twV KpOdO@V Kai EUvooUV tNV
avánrugn twv hoiuógewv"
3) H eionvoD 100% ofuyóvou KaTaOTpÉpEl tOUS Kpooooús Kai tn uikpoÑioKTÓVO Spáan tov
uaKpopáy@v pe anotÉAEOHa tnv eupávion tng NT".
42
O Cross (1980) avakOiv@oE óu n SiatapaxD tav unxaviouúv áuuvas tou aotevD anó tn
badikn tou võgO EIVaI nepiocotEpo onuavtIkn ano tn diadwAnvwon tns tpaxeias Kai tnv un-
xavIKÁ UnootDpin tnç avanvong". Anóta supDuara tns HEAEnS Has npoKUnTEl ótu n unxavikD
unootipi n tns avanvons npénei va 6iakóntetai óiav õev unápxEI anó^urn évder¿n, apoú
anotehei évav en1ndéoV KaI Hádiota onyavukó napayovta diatapaxng twv unxaviouÓv áuuvaç
tOu opyaviouoú.
H OeuKn ouOxÉIon ueragú rou anoiKioyoú tou avarnveUOtnpa ue Gram apvntxá öakthpa
KaI tng NN nou mapatnpiênke orous aofeveiç tns HEdÉtnS Has unopeí va opeiherai otov ano
KiIguó tOU avanveuoukoú ouothuatos pe Gram apvntuxá 6aKtnpia. Eniong n Kavótnta avtáov
TOV IKpoopyaviou@V va enizoúv oe Uypó nepiõánhov (pt»xó oe Bpernt1Ká ovOTatiKá eívai o
KUpiótEpog napayovtaç eLpávions Kai napauovD tOUS otiS dwAnv@dEIS TOU avanveuatnpa".
avántung tnç NIT. Anó ta napanáv® npoKútEI ÓUI TO nAUOILO twV XEpIÓv 9a npénei va sivC * *
H unxavIKD unootnpiÇn tns avanvoDs npéneiva 8iaKóntetai órav dev unápxei anónutn
Evöein, uE anotEhEOLa va Helúvovtai onuavuIKá O1 xEipioLoí náv» otov aoeevD D tov
avanveuothpa yeyovÓç nou oônyeíotn ueíwon tns auxvótntaç tnç NII, toU KóOtOUS voon-
heias, tn öiápkEiaçvoonAEÍaç Kai otnv aú nan tou apiêuoú twv ôia6£oIuoV KpEôatiúv otnv
*******
43
AMES.
O avanveuotnpES anoikizovtai uE Gram apvntiká öaKtHpia Kupíws Acinetobacter Kai
Pseudomonas.
-O1agtEvEis uE unxaviKN UnoOtnpign tnS avanvons eivai n apx1xD nnyD anOIKIgUOÚ THv
avanveuothpwv (92%).
Ta xépia tou npoGwnixoÚ anoikizoVtai Katá tn biápkEIa BepanevtIk@v npá~ewv, ónwS n
öiadwnnvwan inç tpaxeia_. n aAayH THV GWANVGEVTOU avariveUGtÁPa, n
anouákpuvan
TOU UVpoÚ twv owinvúoeov KaI n
avappópnon tov eKKpidewv. Ztn guVÉXEIa uEraðiöouv
ta oaKthpia dtouç ao6eveísta onoia oônyoúv de ôiaotaupoúuevn doíuwfn. (Cross Infection)
KaI oto nepióáinov Tov ad6eváv (Cross Contamination), yeyovó_ nou deíxvei óti n avtt
onyia tov xE pIúV KaI n ahayD tov yavtiáv uetá tnv EKtÉÀEOn tov eepaneutKóv npáßeav
civai ta onovðaiÓrEpa uétpa npóhnyns tnç NII onv AMEO.
HvoonheuTIkn ppovtiða tav ôiaooinvouévov adtevóv oxetízovtai ue tnv eupávan tns
NIL EnouÉVIS, n Noon^evtIKÁ unopeí va naigei onuavtiKó pó|o otn uáxn ue tn NI yia tn
HEíDOn tNç voonpótntaç. tou KóOTOUS VOoonheias. tou KóOTOUS anó anú^eia epyatowpáv,
TOU KóOToug anó tnv anú^eia noiótntas zoDs twv adeeváv, KaI tn 6eAtíwon tns npoope-
póuevns ppovtiðaç tav öapiá appúotwv ue unxavIxD avanvoD otnv AMEO.
BIBAIOTPADIA
1. HALEY R., CULVER D.. WHITE S.. MORGAN W., EMORIT: The nationwide nosocomial
infection rate. A new need for vitai statistics. Am. J. Epidemiol. 1985. 121: 159-167.
2) CROSS A., ROUPE B.: Role of respiratory assistance devices in endemic nosocomial
pneumonia. American Journal of Medicine 1981. 70:681-685.
3. HALEY et al. Nosocomial infections in US hospitals, 1975-1976: estimated frequency by
selected characteristics of patients. American Journal of Medicine 1981, 70: 947-959.
4. GARIBALTI R.A., BRITT MR., COLEMAN M.L.. READINGJ.C.. PACEN.L: Risk factors for
70:677-80.
postoperative pneumonia. Am. J. Med. 1981,
5. STEVENS R.M., TERES D.. SKILLMAN J.. FEINGOLD D.: Pneumonia in an intensive care
625-628
7. SANFORD J., PIERCE A.:Lower respiratory tract infections. In: Hospital Infections. Bennett
J. Brachman P. (Eds). Boston. Litle. Brown and Company, 1979: 255-286.
Sons 1971:
8. ARMITAGE P.: Statistical Methods in Medical Research. New York. Wiley and
380-384.
mechanical ven-
9. JIMENEZ P. et al: Incidence and etiology of pneumonia acquired during
tilation.
10. Du MOULIN G. et al.: Aspiration of gastric bacteria in antacid - treated patients: A frequent
cause of posto-perative colonization of the airway. Lancet 1982, 1:242-245.
11. PENNIGTONG.: Recent advances in the of pneumonia in the intensive care unit.
treatment