Banerjee S N, Emori T G, Culver D H, Gaynes R P, Jarvis W R, Horan T, Edwards J R, Tolson J, Henderson T, Martone W J
Hospital Infections Program, Centers for Disease Control, Atlanta, Georgia 30333.
Am J Med. 1991 Sep 16;91(3B):86S-89S. doi: 10.1016/0002-9343(91)90349-3.
More than 25,000 primary bloodstream infections (BSIs) were identified by 124 National Nosocomial Infections Surveillance System hospitals performing hospital-wide surveillance during the 10-year period 1980-1989. These hospitals reported 6,729 hospital-months of data, during which time approximately 9 million patients were discharged. BSI rates by hospital stratum (based on bed size and teaching affiliation) and pathogen groups were calculated. In 1989, the overall BSI rates for small (less than 200 beds) nonteaching, large nonteaching, small (less than 500 beds) teaching, and large teaching hospitals were 1.3, 2.5, 3.8, and 6.5 BSIs per 1,000 discharges, respectively. Over the period 1980-1989, significant increases (p less than 0.0001) were observed within each hospital stratum, in the overall BSI rate and the BSI rate due to each of the following pathogen groups: coagulase-negative staphylococci, Staphylococcus aureus, enterococci, and Candida species. In contrast, the BSI rate due to gram-negative bacilli remained stable over the decade, in all strata. Except for small nonteaching hospitals, the greatest increase in BSI rates was observed in coagulase-negative staphylococci (the percentage increase ranged between 424% and 754%), followed by Candida species (219-487%). In small nonteaching hospitals, the greatest increase was for S. aureus (283%), followed by enterococci (169%) and coagulase-negative staphylococci (161%). Our analysis documents the emergence over the last decade of coagulase-negative staphylococci as one of the most frequently occurring pathogens in BSI.
在1980年至1989年的10年期间，124家参与全国医院感染监测系统的医院进行全院范围监测，共识别出超过25000例原发性血流感染（BSIs）。这些医院报告了6729个医院月的数据，在此期间约有900万患者出院。计算了按医院分层（基于床位规模和教学附属关系）和病原体组别的BSI率。1989年，小型（少于200张床位）非教学医院、大型非教学医院、小型（少于500张床位）教学医院和大型教学医院的总体BSI率分别为每1000例出院患者中有1.3例、2.5例、3.8例和6.5例BSIs。在1980年至1989年期间，在每个医院分层中，总体BSI率以及以下每种病原体组别的BSI率均出现显著增加（p小于0.0001）：凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌和念珠菌属。相比之下，革兰氏阴性杆菌导致的BSI率在这十年中在所有分层中均保持稳定。除小型非教学医院外，BSI率增幅最大的是凝固酶阴性葡萄球菌（增幅百分比在424%至754%之间），其次是念珠菌属（219% - 487%）。在小型非教学医院中，增幅最大的是金黄色葡萄球菌（283%），其次是肠球菌（169%）和凝固酶阴性葡萄球菌（161%）。我们的分析证明，在过去十年中，凝固酶阴性葡萄球菌已成为BSI中最常见的病原体之一。
