Vonberg Ralf-Peter, Behnke M, Geffers C, Sohr D, Ruden H, Dettenkofer M, Gastmeier P
Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany.
Infect Control Hosp Epidemiol. 2006 Apr;27(4):357-61. doi: 10.1086/503339. Epub 2006 Mar 17.
Reference data from intensive care units (ICUs) are not applicable to non-ICU patients because of the differences in device use rates, length of stay, and severity of underlying diseases among the patient populations. In contrast to the huge amount of data available for ICU patients, appropriate surveillance data for non-ICU patients have been missing in Germany.
To establish a new module ("DEVICE-KISS") of the German Nosocomial Infection Surveillance System for generating stratified reference data for non-ICU wards.
Non-ICU patients from 42 German hospitals.
Monthly patient-days, device-days and nosocomial infections (NIs) (using Centers for Disease Control and Prevention definitions) were counted. Device use rates were calculated, and NI rates were stratified by different medical specialities.
From July 2002 through June 2004, among the 77 wards, there were a total of 536,955 patient-days and 74,188 device-days (for CVC-associated primary bloodstream infections, there were 181,401 patient-days and 8,317 central vascular catheter [CVC]-days in 29 wards; for urinary catheter-associated urinary tract infections, there were 445,536 patient-days and 65,871 urinary catheter-days in 65 wards) and 483 NIs (36 bloodstream infections and 447 urinary tract infections). The mean device use rates were 4.6 device-days per 100 patient-days for CVCs (29 wards) and 14.8 device-days per 100 patient-days for urinary catheters (65 wards), respectively. Mean device-associated NI rates were 4.3 infections per 1,000 CVC-days for CVC-associated bloodstream infections and 6.8 infections per 1,000 urinary catheter-days for catheter-associated urinary tract infections.
DEVICE-KISS allows non-ICUs to recognize an outlier position with regard to NIs by providing well-founded reference data for non-ICU patients.
重症监护病房（ICU）的参考数据不适用于非ICU患者，因为不同患者群体在设备使用率、住院时间和基础疾病严重程度方面存在差异。与大量可用于ICU患者的数据相比，德国缺乏针对非ICU患者的适当监测数据。
为德国医院感染监测系统建立一个新模块（“DEVICE-KISS”），以生成非ICU病房的分层参考数据。
来自42家德国医院的非ICU患者。
统计每月的患者日、设备日和医院感染（NI，采用美国疾病控制与预防中心的定义）。计算设备使用率，并按不同医学专科对NI率进行分层。
2002年7月至2004年6月期间，在77个病房中，共有536,955个患者日和74,188个设备日（对于中心静脉导管相关原发性血流感染，29个病房有181,401个患者日和8,317个中心静脉导管[CVC]日；对于导尿管相关尿路感染，65个病房有445,536个患者日和65,871个导尿管日）以及483例医院感染（36例血流感染和447例尿路感染）。CVC的平均设备使用率分别为每100个患者日4.6个设备日（29个病房），导尿管为每100个患者日14.8个设备日（65个病房）。与设备相关的NI平均发生率为中心静脉导管相关血流感染每1000个CVC日4.3例感染，导尿管相关尿路感染每1000个导尿管日6.8例感染。
DEVICE-KISS通过为非ICU患者提供有充分依据的参考数据，使非ICU病房能够识别医院感染方面的异常情况。
