{"id":3404,"date":"2020-10-01T10:00:00","date_gmt":"2020-10-01T10:00:00","guid":{"rendered":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/?p=3404"},"modified":"2026-05-15T21:35:37","modified_gmt":"2026-05-15T21:35:37","slug":"riscul-infectios-manevre-invazive","status":"publish","type":"post","link":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/?p=3404","title":{"rendered":"Riscul infec\u021bios asociat manevrelor invazive"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-margin-top:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1365px;margin-left: calc(-5% \/ 2 );margin-right: calc(-5% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.375%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:2.375%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:2.375%;--awb-spacing-left-medium:2.375%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:2.375%;--awb-spacing-left-small:2.375%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-center fusion-title-text fusion-title-size-one\" style=\"--awb-margin-top-small:10px;--awb-margin-right-small:0px;--awb-margin-bottom-small:10px;--awb-margin-left-small:0px;\"><h1 class=\"fusion-title-heading title-heading-center\" style=\"margin:0;\">Riscul infec\u021bios asociat manevrelor invazive<\/h1><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:20px;--awb-padding-bottom:10px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 1300px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-right:20px;--awb-padding-left:20px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-max-width:500px;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"1170\" height=\"409\" title=\"logo-spital-2\" src=\"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2.png\" data-orig-src=\"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2.png\" alt class=\"lazyload img-responsive wp-image-3403\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271170%27%20height%3D%27409%27%20viewBox%3D%270%200%201170%20409%27%3E%3Crect%20width%3D%271170%27%20height%3D%27409%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2-200x70.png 200w, https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2-400x140.png 400w, https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2-600x210.png 600w, https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2-800x280.png 800w, https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/wp-content\/uploads\/2026\/05\/logo-spital-2.png 1170w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 700px) 100vw, 1170px\" \/><\/span><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-bottom:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 1300px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-right:20px;--awb-padding-left:20px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><p style=\"color:#777;font-size:0.95em;margin:0;padding:8px 0 4px 0;\"><em><span style=\"color: var(--awb-color2);\">18 iunie 2020<\/span><\/em><\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:10px;--awb-padding-bottom:30px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:calc( 1300px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-padding-right:20px;--awb-padding-left:20px;--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:100%;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-2\"><p>Managementul riscului clinic presupune un ansamblu de ac\u021biuni complexe care vizeaz\u0103 \u00eembunat\u0103\u021birea calit\u0103\u021bii asisten\u021bei medicale, garantarea siguran\u021bei pacien\u021bilor.<\/p>\n<p>Siguran\u021ba pacientului reprezint\u0103 complexul de m\u0103suri \u0219i proceduri de identificare, analiz\u0103 \u0219i management al riscurilor sau incidentelor pe care spitalul nostru le adopt\u0103, pentru a furniza servicii mai sigure \u0219i pentru a minimiza riscul de afectare (v\u0103t\u0103mare) al pacien\u021bilor.<\/p>\n<p>Organiza\u021bia Mondial\u0103 a S\u0103n\u0103t\u0103\u021bii estimeaz\u0103 c\u0103 la nivel mondial, 5-12% dintre pacien\u0163ii spitaliza\u0163i dezvolt\u0103 o infec\u0163ie asociat\u0103 asisten\u0163ei medicale (IAAM), dintre care mai mult de 60% sunt asociate implant\u0103rii unui dispozitiv medical sau chirurgical.<\/p>\n<p>Orice dispozitiv medical implantat, cu titlu provizoriu sau permanent, poate deveni sediul unei eventuale infec\u021bii asociate (sonda urinar\u0103, canul\u0103 de intuba\u0163ie, valv\u0103 cardiac\u0103, protez\u0103 vascular\u0103 sau ortopedic\u0103, dispozitiv intrauterin, etc). Parcursul pacientului spitalizat, ca \u0219i activitatea personalului medico \u2013 sanitar, comport\u0103 o serie de evenimente care vor interveni cu o probabilitate necunoscut\u0103 dar posibil de evaluat.<\/p>\n<p>Cele mai frecvente localiz\u0103ri ale procesului infec\u0163ios sunt \u00een ordine descresc\u0103toare, dup\u0103 statisticile europene: infec\u0163iile urinare (40%), infec\u021biile respiratorii (20%), infec\u021biile de cateter (18\u201325%) \u015fi infec\u0163iile de plag\u0103 operatorie (15%).<\/p>\n<p>Pentru sec\u021bia de terapie intensiv\u0103, caracteristica important\u0103 a infec\u0163iilor este aceea c\u0103 sunt \u00een leg\u0103tur\u0103 direct\u0103 sau indirect\u0103 cu tehnicile invazive care supleeaz\u0103 o func\u0163ie vital\u0103, necesit\u0103 utilizarea unui corp str\u0103in (dispozitiv invaziv) care scurtcircuiteaz\u0103 mijloacele de ap\u0103rare fiziologice (piele, mucoase, sfinctere).<\/p>\n<p>Tehnicile sau dispozitivele \u00eencriminate sunt: ventila\u0163ia artificial\u0103, sondajul urinar, cateterele intravasculare \u015fi actul chirurgical.<\/p>\n<p>Afec\u0163iunea ini\u0163ial\u0103, acut\u0103, grav\u0103 sau existen\u0163a unei infec\u0163ii tratate cu antibiotice, contribuie la diminuarea capacit\u0103\u0163ii de ap\u0103rare natural\u0103 \u015fi cresc riscul de infec\u0163ie secundar\u0103.<\/p>\n<p>Abordul vascular, drenajul urinar sau ventila\u021bia asistat\u0103 sunt acte medicale invazive indispensabile stadiului actual al asisten\u021bei medicale moderne. Fiziopatologia acestor infec\u0163ii este legat\u0103 ini\u021bial de constituirea unui biofilm la nivelul acestor corpuri str\u0103ine reprezentate de dispozitivele medicale. Biofilmul este reprezentat de o aglomerare plurimicrobian\u0103 fixat\u0103 pe suprafa\u0163a inert\u0103 sau vie \u015fi men\u0163inut\u0103 pe aceast\u0103 suprafa\u0163\u0103 de secre\u0163ia unei matrici adezive, protectoare, structur\u0103 vie, dinamic\u0103, \u020bn permanent\u0103 remaniere. Chiar dac\u0103 tehnicile aseptice sunt respectate \u020bn timpul implant\u0103rii \/ folosirii dispozitivului medical, dezvoltarea biofilmului este rapid\u0103 la nivelul majorit\u0103\u0163ii materialelor utilizate \u020bn medicina uman\u0103. Consecin\u0163ele medicale dup\u0103 constituirea biofilmului sunt majore: limitarea reac\u0163iei imunitare locale (anticorpi, fagocite), sc\u0103derea sensibilit\u0103\u0163ii diagnosticului microbiologic \u015fi nu \u020bn ultimul r\u0203nd, apari\u021bia antibioticorezisten\u021bei.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":3403,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[72],"tags":[],"class_list":["post-3404","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stil-de-viata-sanatos"],"_links":{"self":[{"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/posts\/3404","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3404"}],"version-history":[{"count":1,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/posts\/3404\/revisions"}],"predecessor-version":[{"id":3413,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/posts\/3404\/revisions\/3413"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=\/wp\/v2\/media\/3403"}],"wp:attachment":[{"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3404"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3404"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/portalweb.spitalulgrigorealexandrescu.ro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3404"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}