Lanini Simone, Jarvis William R, Nicastri Emanuele, Privitera Gaetano, Gesu Giovanni, Marchetti Federico, Giuliani Luigi, Piselli Pierluca, Puro Vincenzo, Nisii Carla, Ippolito Giuseppe
Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy.
Infect Control Hosp Epidemiol. 2009 Jul;30(7):659-65. doi: 10.1086/597596.
Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.
Three point-prevalence surveys.
A total of 9,609 patients were surveyed.
The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAI. Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.
Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.
医疗保健相关感染(HAIs)是全球发病和死亡的重要原因。在2002年至2004年期间,一组意大利医院被招募来进行HAIs现患率调查。
三次现患率调查。
共对9609名患者进行了调查。
HAIs的总体发生率为6.7%(在9609名被调查患者中有645例感染)。最常见的HAIs是下呼吸道感染,占所有HAIs的35.8%(645例HAIs中的231例),其次是尿路感染(645例HAIs中的152例[23.6%])、血流感染(645例HAIs中的90例[14.0%])和手术部位感染(645例HAIs中的79例[12.2%])。在多变量和单变量分析中,侵入性操作、住院时间、化疗、创伤、昏迷和医院地点都是与HAIs发生在统计学上显著相关的因素。肠杆菌科是在内科和外科病房分离出的最常见菌株,而革兰氏阴性需氧杆菌是在重症监护病房分离出的最常见菌株。在我们研究时,所有被调查患者中约有一半正在接受抗生素治疗;在内科病房最常用的抗生素类别是氟喹诺酮类,在外科病房是头孢菌素类,在重症监护病房是青霉素类和糖肽类。
我们的研究强调需要实施进一步的HAIs监测,以便为国家卫生系统提供预防和管理住院患者感染的适当工具。