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科威特的设备相关感染率、细菌耐药性、住院时间和死亡率:国际医院感染控制联盟的研究结果。

Device-associated infection rates, bacterial resistance, length of stay, and mortality in Kuwait: International Nosocomial Infection Consortium findings.

作者信息

Al-Mousa Haifaa Hassan, Omar Abeer Aly, Rosenthal Víctor Daniel, Salama Mona Foda, Aly Nasser Yehia, El-Dossoky Noweir Mohammad, Rebello Flavie Maria, Narciso Dennis Malungcot, Sayed Amani Fouad, Kurian Anu, George Sneha Mary, Mohamed Amna Mostafa, Ramapurath Ruby Jose, Varghese Suga Thomas

机构信息

Infection Control Directorate, Ministry of Health, Kuwait City, Kuwait.

International Nosocomial Infection Control Consortium, Buenos Aires, Argentina.

出版信息

Am J Infect Control. 2016 Apr 1;44(4):444-9. doi: 10.1016/j.ajic.2015.10.031. Epub 2016 Jan 5.

Abstract

BACKGROUND

To report the results of the International Infection Control Consortium (INICC) study conducted in Kuwait from November 2013-March 2015.

METHODS

A device-associated health care-acquired infection (DA-HAI) prospective surveillance study in 7 adult, pediatric, and neonatal intensive care units (ICUs) using the U.S. Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN) definitions and INICC methods.

RESULTS

We followed 3,732 adult and pediatric patients for 21,611 bed days and 671 neonatal patients for 4,515 bed days. In the medical-surgical ICUs, the central line-associated bloodstream infection (CLABSI) rate was 3.5 per 1,000 central line days, the ventilator-associated pneumonia (VAP) rate was 4.0 per 1,000 mechanical ventilator days, and the catheter-associated urinary tract infection (CAUTI) rate was 3.3 per 1,000 urinary catheter days; all of them were lower than INICC rates (CLABSI: 4.9; VAP: 16.5; and CAUTI: 5.3) and higher than NHSN rates (CLABSI: 0.9; VAP: 1.1; and CAUTI: 1.2). Resistance of Staphylococcus aureus to oxacillin was 100%, resistance of Acinetobacter baumannii to imipenem and meropenem was 77.6%, and resistance of Klebsiella pneumoniae to imipenem and meropenem was 29.4%. Extra length of stay was 27.1 days for CLABSI, 22.2 days for VAP, and 19.2 days for CAUTI in adult and pediatric ICUs. Extra crude mortality was 19.9% for CLABSI, 30.9% for VAP, and 11.1% for CAUTI in adult and pediatric ICUs.

CONCLUSIONS

DA-HAI rates in our ICUs are higher than the CDC-NSHN rates and lower than the INICC international rates.

摘要

背景

报告2013年11月至2015年3月在科威特开展的国际感染控制联盟(INICC)研究的结果。

方法

在7个成人、儿科和新生儿重症监护病房(ICU)开展一项与设备相关的医疗保健相关感染(DA-HAI)前瞻性监测研究,采用美国疾病控制与预防中心(CDC)的国家医疗安全网络(NHSN)定义和INICC方法。

结果

我们对3732例成人和儿科患者进行了21611个床日的随访,对671例新生儿患者进行了4515个床日的随访。在内外科ICU中,中心静脉导管相关血流感染(CLABSI)发生率为每1000个中心静脉导管日3.5例,呼吸机相关性肺炎(VAP)发生率为每1000个机械通气日4.0例,导尿管相关尿路感染(CAUTI)发生率为每1000个导尿管日3.3例;所有这些发生率均低于INICC发生率(CLABSI:4.9;VAP:16.5;CAUTI:5.3),高于NHSN发生率(CLABSI:0.9;VAP:1.1;CAUTI:1.2)。金黄色葡萄球菌对苯唑西林的耐药率为100%,鲍曼不动杆菌对亚胺培南和美罗培南的耐药率为77.6%,肺炎克雷伯菌对亚胺培南和美罗培南的耐药率为29.4%。在成人和儿科ICU中,CLABSI导致的额外住院时间为27.4天,VAP为22.2天,CAUTI为19.2天。成人和儿科ICU中,CLABSI导致的额外粗死亡率为19.9%,VAP为30.9%,CAUTI为11.1%。

结论

我们ICU中的DA-HAI发生率高于CDC-NHSN发生率,低于INICC国际发生率。

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