Bonnal C, Birgand G, Lolom I, Diamantis S, Dumortier C, L'Heriteau F, Armand-Lefevre L, Lucet J C
Unité d'hygiène et de lutte contre les infections nosocomiales, hôpital Bichat-Claude-Bernard, Paris, France.
Unité d'hygiène et de lutte contre les infections nosocomiales, hôpital Bichat-Claude-Bernard, Paris, France.
Med Mal Infect. 2015 Mar;45(3):84-8. doi: 10.1016/j.medmal.2015.01.002. Epub 2015 Feb 9.
Surveillance of preventable healthcare associated infections and feedback of the results to clinicians is central in the efforts to improve performance. We assessed Staphylococcus aureus healthcare associated bloodstream infection (HA-BSI) as an indicator of healthcare quality.
Between 2002 and 2012, we carried out a ten-year prospective bedside surveillance of S. aureus healthcare associated bacteraemia in a 940-bed university hospital using standard definitions.
Overall, 2784 HA-BSI were identified during the study period, among which 573 (18%) were due to S. aureus. Among these 573 S. aureus bacteraemias, 189 originated from intravascular catheters (32.8%) of which 84% (158/189) in patients outside intensive care units. The proportion of catheter related HA-BSI due to S. aureus was 56% (61/109) in PVC-related HA-BSI and 34% (103/301) in CVC-related HA-BSI. A sharp decrease of PVC-related HA-BSI from 20 to 7 per year was obtained during the same period.
In our experience, S. aureus HA-BSI is a simple and useful indicator of catheter associated infections, and therefore of healthcare quality, especially in units not covered by other type of surveillance.
监测可预防的医疗相关感染并将结果反馈给临床医生是提高医疗质量的核心工作。我们评估了金黄色葡萄球菌医疗相关血流感染（HA-BSI）作为医疗质量的一项指标。
在2002年至2012年期间，我们在一家拥有940张床位的大学医院，采用标准定义对金黄色葡萄球菌医疗相关菌血症进行了为期十年的前瞻性床边监测。
总体而言，在研究期间共识别出2784例HA-BSI，其中573例（18%）由金黄色葡萄球菌引起。在这573例金黄色葡萄球菌菌血症中，189例源自血管内导管（32.8%），其中84%（158/189）发生在非重症监护病房的患者中。在聚氯乙烯（PVC）相关的HA-BSI中，由金黄色葡萄球菌引起的导管相关HA-BSI比例为56%（61/109），在中心静脉导管（CVC）相关的HA-BSI中为34%（103/301）。同期PVC相关的HA-BSI从每年20例急剧下降至7例。
根据我们的经验，金黄色葡萄球菌HA-BSI是导管相关感染的一个简单且有用的指标，因此也是医疗质量的指标，尤其在未进行其他类型监测的科室。
