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评估马里兰州鲍曼不动杆菌的负担:全州横断面期间患病率调查。

Assessing the burden of Acinetobacter baumannii in Maryland: a statewide cross-sectional period prevalence survey.

机构信息

University of Maryland School of Medicine, Baltimore, Maryland, USA.

出版信息

Infect Control Hosp Epidemiol. 2012 Sep;33(9):883-8. doi: 10.1086/667376. Epub 2012 Jul 23.

Abstract

OBJECTIVE

To determine the prevalence of Acinetobacter baumannii, an important healthcare-associated pathogen, among mechanically ventilated patients in Maryland.

DESIGN

The Maryland MDRO Prevention Collaborative performed a statewide cross-sectional active surveillance survey of mechanically ventilated patients residing in acute care and long-term care (LTC) facilities. Surveillance cultures (sputum and perianal) were obtained from all mechanically ventilated inpatients at participating facilities during a 2-week period.

SETTING

All healthcare facilities in Maryland that provide care for mechanically ventilated patients were invited to participate.

PATIENTS

Mechanically ventilated patients, known to be at high risk for colonization and infection with A. baumannii, were included.

RESULTS

Seventy percent (40/57) of all eligible healthcare facilities participated in the survey, representing both acute care ([Formula: see text]) and LTC ([Formula: see text]) facilities in all geographic regions of Maryland. Surveillance cultures were obtained from 92% (358/390) of eligible patients. A. baumannii was identified in 34% of all mechanically ventilated patients in Maryland; multidrug-resistant A. baumannii was found in 27% of all patients. A. baumannii was detected in at least 1 patient in 49% of participating facilities; 100% of LTC facilities had at least 1 patient with A. baumannii, compared with 31% of acute care facilities. A. baumannii was identified from all facilities in which 10 or more patients were sampled.

CONCLUSIONS

A. baumannii is common among mechanically ventilated patients in both acute care and LTC facilities throughout Maryland, with a high proportion of isolates demonstrating multidrug resistance.

摘要

目的

确定马里兰州机械通气患者中一种重要的医疗保健相关病原体鲍曼不动杆菌的流行情况。

设计

马里兰州 MDRO 预防合作组织对居住在急性护理和长期护理(LTC)设施中的机械通气患者进行了全州范围的横断面主动监测调查。在为期两周的时间内,从参与设施中的所有机械通气住院患者中采集监测培养物(痰和肛周)。

设置

邀请马里兰州所有提供机械通气患者护理的医疗保健设施参与。

患者

包括已知具有鲍曼不动杆菌定植和感染高风险的机械通气患者。

结果

70%(40/57)的所有合格医疗保健设施参与了调查,代表马里兰州所有地理区域的急性护理([Formula: see text])和 LTC([Formula: see text])设施。从 92%(358/390)的合格患者中获得了监测培养物。在马里兰州所有机械通气患者中,鲍曼不动杆菌的检出率为 34%;所有患者中耐多药鲍曼不动杆菌的检出率为 27%。在 49%的参与设施中至少有 1 名患者检测到鲍曼不动杆菌;100%的 LTC 设施至少有 1 名患者携带鲍曼不动杆菌,而急性护理设施为 31%。在所有采样 10 名或以上患者的设施中均鉴定出鲍曼不动杆菌。

结论

在马里兰州的急性护理和 LTC 设施中,机械通气患者普遍存在鲍曼不动杆菌,且分离株中多药耐药的比例很高。

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