Department of Internal Medicine, Far-Eastern Memorial Hospital, Taipei, Taiwan.
J Microbiol Immunol Infect. 2010 Oct;43(5):416-29. doi: 10.1016/S1684-1182(10)60065-5.
BACKGROUND/PURPOSE: Healthcare-associated infections, formerly known as nosocomial infections, are one of the most important issues in current practice. Understanding trends in overall infection rates, as well as their incidence and proportion among different causative organisms, can help us to better define our infection control methods and therapy goals. To understand the changing epidemiology of nosocomial bloodstream infections (BSI) in Taiwan, we retrospectively collected nosocomial infection data from 11 hospitals and examined the trends and changing patterns of nosocomial BSI.
Eleven major teaching hospitals in Taiwan were invited to participate in the study. The overall density of nosocomial infections and major BSI-causing organisms, including Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and Candida species, were collected. The distribution of the different Candida species was also recorded. Background parameters from the 11 hospitals, including the size of the hospital, hospital capacity, the number of blood stream infection events, and average length of stay, were also recorded.
The incidence of nosocomial BSI ranged 0.23-2.56 per 1,000 patient-days, which accounted for 8-43% of all nosocomial infections. The most common causative organism of nosocomial bacteremia was S. aureus, ranging 0.88-0.01 per 1,000 patient-days. Overall, the incidence of S. aureus bacteremia has decreased over the last 13 years, but this difference was not statistically significant (p = 0.053). The rate of Candida fungemia (p < 0.01) and A. baumannii (p = 0.03) bacteremia increased significantly. C. albicans accounted for most cases of nosocomial fungemia, ranging from 40% to 80%, followed by Candida tropicalis, Candida parapsilosis and Candida glabrata. However, the incidence varied significantly from hospital to hospital, and the highest incidence was observed in a cancer center.
The overall incidence rate of S. aureus bacteremia in the 11 major hospitals studied had decreased over the last decade, though the difference was not statistically significant. However, the rate of Candida fungemia and A. baumannii bacteremia had increased significantly.
背景/目的：医疗保健相关感染，以前称为医院获得性感染，是当前实践中的一个重要问题。了解总体感染率的趋势，以及它们在不同病原体中的发病率和比例，可以帮助我们更好地定义感染控制方法和治疗目标。为了了解台湾地区医院获得性血流感染（BSI）的不断变化的流行病学，我们回顾性地从 11 家医院收集了医院感染数据，并检查了医院获得性 BSI 的趋势和变化模式。
邀请台湾的 11 家主要教学医院参加研究。收集了包括金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌和念珠菌属在内的总体医院感染密度和主要 BSI 病原体，以及不同念珠菌属的分布情况。还记录了 11 家医院的背景参数，包括医院规模、医院容量、血流感染事件数量和平均住院时间。
医院获得性 BSI 的发病率为 0.23-2.56/1000 患者天，占所有医院感染的 8-43%。医院获得性菌血症最常见的病原体是金黄色葡萄球菌，为 0.88-0.01/1000 患者天。总体而言，金黄色葡萄球菌菌血症的发病率在过去 13 年中有所下降，但差异无统计学意义（p = 0.053）。念珠菌血症（p < 0.01）和鲍曼不动杆菌菌血症（p = 0.03）的发生率显著增加。医院获得性真菌血症以白色念珠菌为主，占 40%-80%，其次是热带念珠菌、近平滑念珠菌和光滑念珠菌。然而，从医院到医院的发病率差异很大，发病率最高的是癌症中心。
在过去十年中，研究的 11 家主要医院金黄色葡萄球菌菌血症的总体发病率有所下降，尽管差异无统计学意义。然而，念珠菌血症和鲍曼不动杆菌菌血症的发生率显著增加。
