Ding Ji-Guang, Sun Qing-Feng, Li Ke-Cheng, Zheng Ming-Hua, Miao Xiao-Hui, Ni Wu, Hong Liang, Yang Jin-Xian, Ruan Zhan-Wei, Zhou Rui-Wei, Zhou Hai-Jiao, He Wen-Fei
Department of Infectious Diseases, The Third Affiliated Hospital to Wenzhou Medical College, Rui'an, Zhejiang, 325200, PR China.
BMC Infect Dis. 2009 Jul 25;9:115. doi: 10.1186/1471-2334-9-115.
Nosocomial infections are a major threat to patients in the intensive care unit (ICU). Limited data exist on the epidemiology of ICU-acquired infections in China. This retrospective study was carried out to determine the current status of nosocomial infection in China.
A retrospective review of nosocomial infections in the ICU of a tertiary hospital in East China between 2003 and 2007 was performed. Nosocomial infections were defined according to the definitions of Centers for Disease Control and Prevention. The overall patient nosocomial infection rate, the incidence density rate of nosocomial infections, the excess length of stay, and distribution of nosocomial infection sites were determined. Then, pathogen and antimicrobial susceptibility profiles were further investigated.
Among 1980 patients admitted over the period of time, the overall patient nosocomial infection rate was 26.8% or 51.0 per 1000 patient days., Lower respiratory tract infections (LRTI) accounted for most of the infections (68.4%), followed by urinary tract infections (UTI, 15.9%), bloodstream (BSI, 5.9%), and gastrointestinal tract (GI, 2.5%) infections. There was no significant change in LRTI, UTI and BSI infection rates during the 5 years. However, GI rate was significantly decreased from 5.5% in 2003 to 0.4% in 2007. In addition, A. baumannii, C. albicans and S. epidermidis were the most frequent pathogens isolated in patients with LRTIs, UTIs and BSIs, respectively. The rates of isolates resistant to commonly used antibiotics ranged from 24.0% to 93.1%.
There was a high and relatively stable rate of nosocomial infections in the ICU of a tertiary hospital in China through year 2003-2007, with some differences in the distribution of the infection sites, and pathogen and antibiotic susceptibility profiles from those reported from the Western countries. Guidelines for surveillance and prevention of nosocomial infections must be implemented in order to reduce the rate.
医院感染是重症监护病房（ICU）患者面临的主要威胁。关于中国ICU获得性感染的流行病学数据有限。本回顾性研究旨在确定中国医院感染的现状。
对中国东部一家三级医院2003年至2007年ICU的医院感染进行回顾性分析。医院感染根据疾病控制与预防中心的定义进行界定。确定总体患者医院感染率、医院感染发病密度率、延长住院时间以及医院感染部位分布。然后，进一步调查病原体及抗菌药物敏感性情况。
在这段时间收治的1980例患者中，总体患者医院感染率为26.8%，即每1000患者日51.0例。下呼吸道感染（LRTI）占感染的大部分（68.4%），其次是尿路感染（UTI，15.9%）、血流感染（BSI，5.9%）和胃肠道感染（GI，2.5%）。5年间LRTI、UTI和BSI感染率无显著变化。然而，GI感染率从2003年的5.5%显著降至2007年的0.4%。此外，鲍曼不动杆菌、白色念珠菌和表皮葡萄球菌分别是LRTI、UTI和BSI患者中最常分离出的病原体。对常用抗生素耐药的分离株比例在24.0%至93.1%之间。
2003 - 2007年期间，中国一家三级医院ICU的医院感染率较高且相对稳定，感染部位分布、病原体及抗生素敏感性情况与西方国家报道有所不同。必须实施医院感染监测和预防指南以降低感染率。
