Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China.
School of Public Health, Peking University, Beijing, China.
J Hosp Infect. 2017 Jan;95(1):105-111. doi: 10.1016/j.jhin.2016.08.010. Epub 2016 Aug 20.
Healthcare-associated infection (HCAI) represents a major problem for patient safety worldwide.
To demonstrate the prevalence, causative agents, and risk factors for HCAI in Chinese hospitals.
A one-day point-prevalence survey was conducted in 52 Chinese hospitals between October 2014 and March 2015. A web-based software system was developed for data entry and management.
Among 53,939 patients surveyed, the prevalence of patients with at least one HCAI was 3.7%. Of 2182 HCAI episodes, the most frequently occurring types were lower respiratory tract infections (47.2%), followed by urinary tract infection (12.3%), upper respiratory tract infection (11.0%), and surgical site infection (6.2%). The prevalence of patients with at least one HCAI in critical care units was highest (17.1%). Device-associated infections, including ventilator-associated pneumonia, catheter-associated urinary tract infection, and central catheter-associated bloodstream infection, accounted for only 7.9% of all HCAIs. The most frequently isolated micro-organisms were Pseudomonas aeruginosa [206 infections (9.4%)], Acinetobacter baumannii [172 infections (7.9%)], Klebsiella pneumoniae [160 infections (7.3%)], and Escherichia coli [145 infections (6.6%)]. Of the survey patients (18,206/53,939), 33.8% were receiving at least one antimicrobial agent at the time of the survey. Risk factors for HCAI included older age (≥80 years), male gender, days of hospital admission, admission into a critical care unit, and device utilization.
Our study suggests that the overall prevalence of HCAI in surveyed Chinese hospitals was lower than that reported from most European countries and the USA. More attention should be given to the surveillance and prevention of non-device-associated HCAI in China.
医疗保健相关感染（HCAI）是全球范围内患者安全的主要问题。
展示中国医院 HCAI 的流行率、病原体和危险因素。
2014 年 10 月至 2015 年 3 月，对 52 家中国医院进行了为期一天的患病率调查。开发了一个基于网络的软件系统用于数据录入和管理。
在所调查的 53939 名患者中，至少有一例 HCAI 的患者患病率为 3.7%。在 2182 例 HCAI 发作中，最常见的类型是下呼吸道感染（47.2%），其次是尿路感染（12.3%）、上呼吸道感染（11.0%）和手术部位感染（6.2%）。重症监护病房（ICU）中至少有一例 HCAI 的患者患病率最高（17.1%）。器械相关感染，包括呼吸机相关性肺炎、导管相关尿路感染和中心导管相关血流感染，仅占所有 HCAI 的 7.9%。最常分离的微生物是铜绿假单胞菌[206 例感染（9.4%）]、鲍曼不动杆菌[172 例感染（7.9%）]、肺炎克雷伯菌[160 例感染（7.3%）]和大肠埃希菌[145 例感染（6.6%）]。在所调查的患者（53939 例中的 18206 例）中，33.8%的患者在调查时至少使用了一种抗菌药物。HCAI 的危险因素包括年龄较大（≥80 岁）、男性、住院天数、入住重症监护病房和使用器械。
我们的研究表明，在所调查的中国医院中，HCAI 的总体患病率低于大多数欧洲国家和美国的报告。中国应更加重视非器械相关 HCAI 的监测和预防。
