[重症监护病房医院感染相关的微生物分离株：参与德国医院感染监测系统（KISS）的274个重症监护病房的数据]

[Microbiological isolates associated with nosocomial infections in intensive care units: data of 274 intensive care units participating in the German Nosocomial Infections Surveillance System (KISS)].

作者信息

Geffers C, Zuschneid I, Sohr D, Rüden H, Gastmeier P

机构信息

Nationales Referenzzentrum für Surveillance von nosokomialen Infektionen.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2004 Jan;39(1):15-9. doi: 10.1055/s-2004-815713.

DOI:10.1055/s-2004-815713

PMID:14740311

Abstract

OBJECTIVE

To describe the frequency and distribution of microbiological isolates in association with nosocomial infections (NI) in intensive care units (ICUs) in Germany.

METHODS

The hospital infection surveillance system (KISS = Krankenhaus-Infektions-Surveillance-System) started in Germany in January 1997 as a nationwide surveillance project for the voluntary registration of nosocomial infections. For ICUs reporting focuses on device-associated primary bloodstream infections, urinary tract infections, as well as on pneumonia and bronchitis. The data collected for each patient who acquires a nosocomial infection include the site of infection and patient demographics. Up to 4 pathogens can be recorded for each infection.

RESULTS

From 1997 until 2002 274 ICUs were participating. The data of 590 695 patients with 18 073 device associated infections (ventilator-associated pneumonia and bronchitis, central line-associated bloodstream infection (BSI) and urinary catheter-associated urinary tract infection (UTI)) were analyzed. In the group of device-associated NI S. aureus was most frequently isolated (16.5/100NI) followed by Ps. aeruginosa (14.2/100NI), E. coli (13.9/100NI), enterococci (13.4/100NI) and C. albicans (11.2/100NI). Of all S. aureus isolates 20.0 % were MRSA. There was an increase of the MRSA rate from 8 % in 1997 to 26.9 % in 2002. The most frequent pathogen in BSI was coagulase-negative staphylococcus (31.0/100NI). In ventilator-associated pneumonia and bronchitis S. aureus was the most frequent pathogen (24.2 and 24.9/100NI). In more than half of all catheter-associated UTI E. coli (25.7/100NI) and enterococci (25.4/100NI) were found. After stratification for the type of ICU differences in the distribution of pathogens could be shown.

CONCLUSIONS

The KISS data give an overview of the most important pathogens associated with nosocomial infections on ICUs in Germany.

摘要

目的

描述德国重症监护病房（ICU）医院感染（NI）相关微生物分离株的频率和分布情况。

方法

医院感染监测系统（KISS = Krankenhaus-Infektions-Surveillance-System）于1997年1月在德国启动，作为一项全国性的医院感染自愿登记监测项目。对于ICU，报告重点关注与器械相关的原发性血流感染、尿路感染以及肺炎和支气管炎。为每例发生医院感染的患者收集的数据包括感染部位和患者人口统计学信息。每次感染最多可记录4种病原体。

结果

1997年至2002年期间，有274个ICU参与。对590695例患者的18073例与器械相关的感染（呼吸机相关性肺炎和支气管炎、中心静脉导管相关性血流感染（BSI）和导尿管相关性尿路感染（UTI））数据进行了分析。在与器械相关的医院感染组中，最常分离出的是金黄色葡萄球菌（16.5/100例医院感染），其次是铜绿假单胞菌（14.2/100例医院感染）、大肠埃希菌（13.9/100例医院感染）、肠球菌（13.4/100例医院感染）和白色念珠菌（11.2/100例医院感染）。在所有金黄色葡萄球菌分离株中，20.0%为耐甲氧西林金黄色葡萄球菌（MRSA）。MRSA率从1997年的8%上升至2002年的26.9%。血流感染中最常见的病原体是凝固酶阴性葡萄球菌（CNS）（31.0/100例医院感染）。在呼吸机相关性肺炎和支气管炎中，金黄色葡萄球菌是最常见的病原体（分别为24.2/100例医院感染和24.9/100例医院感染）。在超过一半的导尿管相关性尿路感染中，发现了大肠埃希菌（25.7/100例医院感染）和肠球菌（25.4/100例医院感染）。按ICU类型分层后，可显示病原体分布的差异。