Choi J Y, Kwak Y G, Yoo H, Lee S-O, Kim H B, Han S H, Choi H J, Kim Y K, Kim S R, Kim T H, Lee H, Chun H K, Kim J-S, Eun B W, Kim D W, Koo H-S, Bae G-R, Lee K
Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea.
J Hosp Infect. 2015 Sep;91(1):28-34. doi: 10.1016/j.jhin.2015.06.002. Epub 2015 Jun 10.
The effectiveness of continuous nationwide surveillance on healthcare-associated infections should be investigated in each country.
To assess the rate of device-associated infections (DAIs) in intensive care units (ICUs) since the establishment of the Korean Nosocomial Infections Surveillance System (KONIS).
Nationwide data were obtained on the incidence rate of DAI in ICUs reported to KONIS by all participating hospitals. The three major DAIs were studied: ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CABSI), and catheter-associated urinary tract infection (CAUTI). The pooled and year-wise incidence rates (cases per 1000 device-days) of these DAIs were determined for the period 2006 and 2012. In addition, data from institutions that had participated in KONIS for at least three consecutive years were analysed separately.
The number of ICUs participating in KONIS gradually increased from 76 in 2006 to 162 in 2012. Between 2006 and 2012, the incidence rate per 1000 device-days for VAP decreased significantly from 3.48 to 1.64 (F = 11, P < 0.01), for CAUTI the rate decreased non-significantly from 1.85 to 1.26 (F = 2.02, P = 0.07), and for CABSI the rate also decreased non-significantly from 3.4 to 2.57 (F = 1.73, P = 0.12). In the 132 ICUs that had participated in KONIS for at least three consecutive years, the VAP rate significantly decreased from the first year to third year (F = 20.57, P < 0.01), but the rates of CAUTI (F = 1.06, P = 0.35) and CABSI (F = 1.39, P = 0.25) did not change significantly.
The decreased incidence rate of VAP in ICUs in Korea might be associated with the continuous prospective surveillance provided by KONIS.
每个国家都应调查全国范围内持续开展的医疗保健相关感染监测的有效性。
评估自韩国医院感染监测系统（KONIS）建立以来重症监护病房（ICU）中器械相关感染（DAI）的发生率。
获取了所有参与医院向KONIS报告的ICU中DAI发病率的全国性数据。研究了三种主要的DAI：呼吸机相关性肺炎（VAP）、中心静脉导管相关血流感染（CABSI）和导尿管相关尿路感染（CAUTI）。确定了2006年至2012年期间这些DAI的合并发病率和逐年发病率（每1000器械日的病例数）。此外，对连续至少三年参与KONIS的机构的数据进行了单独分析。
参与KONIS的ICU数量从2006年的76个逐渐增加到2012年的162个。2006年至2012年期间，VAP每1000器械日的发病率从3.48显著降至1.64（F = 11，P < 0.01），CAUTI的发病率从1.85降至1.26，下降不显著（F = 2.02，P = 0.07），CABSI的发病率也从3.4降至2.57，下降不显著（F = 1.73，P = 0.12）。在连续至少三年参与KONIS的132个ICU中，VAP发病率从第一年到第三年显著下降（F = 20.57，P < 0.01），但CAUTI（F = 1.06，P = 0.35）和CABSI（F = 1.39，P = 0.25）的发病率没有显著变化。
韩国ICU中VAP发病率的下降可能与KONIS提供的持续前瞻性监测有关。
