Kuzdan Canan, Soysal Ahmet, Culha Gulcan, Altinkanat Gulsen, Soyletir Guner, Bakir Mustafa
Marmara University Medical School, Istanbul, Turkey.
J Infect Dev Ctries. 2014 Nov 13;8(11):1415-20. doi: 10.3855/jidc.3931.
Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries. As information on the epidemiology of HCAIs in pediatric patientsinTurkey is limited, we decided to study the annual incidence and antibiotic resistance patterns in our pediatric ward at Marmara University Hospital.
All hospitalized patients in the pediatric ward were assessed with regard to HCAIs between January 1, 2008 and December 31, 2010. Data was prospectively collected according to standard protocols of the National Nosocomial Infections Surveillance System (NosoLINE).
A total of 16.5% of all hospitalized patients developed HCAIs in the three years studied. The most frequent HCAIs were urinary tract infections (UTI) (29.3%), bloodstream infections (27%) and pneumonias (21%). While the most frequent agent isolatedfrom UTI was Escherichia coli (26%), the most common agent in blood stream infections was Staphylococcus epidermidis (30.4%). Vancomycin resistance was found in 73.3% of all Enterococcus faecium strains. Extended-spectrum β-lactamase was detected in 58.3% of Klebsiella pneumoniae and E. coli isolates.
Continual HCAI surveillance is important to determineits rate. Knowledge of the HCAI incidence can influence people's use of broad-spectrum antibiotics and encourage antibiotic rotation. Moreover, the knowledge of HCAI incidence may support the infection control programmes, including education and isolation methods which ultimately may help to reducethe rate of the HCAIs.
医疗保健相关感染(HCAIs)会导致发病率、死亡率上升以及成本增加,在发展中国家尤其如此。由于土耳其儿科患者中HCAIs的流行病学信息有限,我们决定研究马尔马拉大学医院儿科病房的年发病率及抗生素耐药模式。
对2008年1月1日至2010年12月31日期间儿科病房的所有住院患者进行HCAIs评估。根据国家医院感染监测系统(NosoLINE)的标准方案前瞻性收集数据。
在研究的三年中,所有住院患者中有16.5%发生了HCAIs。最常见的HCAIs是尿路感染(UTI)(29.3%)、血流感染(27%)和肺炎(21%)。从UTI中分离出的最常见病原体是大肠杆菌(26%),而血流感染中最常见的病原体是表皮葡萄球菌(30.4%)。在所有粪肠球菌菌株中,73.3%发现对万古霉素耐药。在58.3%的肺炎克雷伯菌和大肠杆菌分离株中检测到超广谱β-内酰胺酶。
持续进行HCAI监测对于确定其发生率很重要。了解HCAI发病率会影响人们对广谱抗生素的使用,并鼓励抗生素轮换。此外,了解HCAI发病率可能有助于感染控制计划,包括教育和隔离方法,最终可能有助于降低HCAIs的发生率。