Institute of Hygiene and Environmental Medicine, Charitέ - Universitätsmedizin Berlin.
Dtsch Arztebl Int. 2017 Dec 15;114(50):851-857. doi: 10.3238/arztebl.2017.0851.
In 2011 and again in 2016, the European Centre for Disease Prevention and Control (ECDC) asked all European countries to carry out nationwide studies on the prevalence of nosocomial infection (NI) and antibiotic use (AU). Data on NI and AU constitute an essential basis for the development of measures to prevent infection and lessen antibiotic resistance.
The German prevalence study of 2016 was carried out according to the ECDC protocol. Alongside a sample of 49 acute-care hospitals requested by the ECDC that was representative in terms of size (number of beds), further hospitals were invited to participate as well. Analyses were made of the overall group (218 hospitals, 64 412 patients), the representative group (49 hospitals), and the core group (46 hospitals). The core group consisted of the hospitals that had participated in the study of 2011.
The prevalence of patients with NI was 4.6% in the overall group in 2016; it had been 5.1% in 2011 (p <0.01). In the representative group, the prevalence was 3.6% (compared to 5.1% in 2011, p <0.01). In the core group, the prevalence of NI was the same in 2016 as it had been in 2011. The prevalence of patients with ABU in the overall group remained the same, but a fall was seen in the representative group (21.5% versus 23.3%; p <0.01) and a rise in the core group (27.3% versus 26.2%; p = 0.02). The staff-patient ratio among the infection prevention and control professionals improved in all three groups.
A decrease in NI and AU prevalence was seen in the representative group, while mixed results were seen in the other analyzed groups. Further efforts to reduce NI and ABA are clearly necessary.
2011 年和 2016 年,欧洲疾病预防控制中心(ECDC)曾两次要求所有欧洲国家开展全国范围内的医院感染(NI)和抗生素使用(AU)患病率研究。NI 和 AU 数据是制定感染预防和减少抗生素耐药性措施的重要基础。
2016 年德国患病率研究是根据 ECDC 方案进行的。除 ECDC 要求的具有代表性的大小(床位数量)的 49 家急性护理医院样本外,还邀请了其他医院参与。对整体组(218 家医院,64412 名患者)、代表性组(49 家医院)和核心组(46 家医院)进行了分析。核心组由参加过 2011 年研究的医院组成。
2016 年整体组 NI 患者患病率为 4.6%;2011 年为 5.1%(p<0.01)。代表性组患病率为 3.6%(与 2011 年的 5.1%相比,p<0.01)。核心组 2016 年 NI 患病率与 2011 年相同。整体组 ABU 患者患病率保持不变,但代表性组(21.5%比 23.3%;p<0.01)和核心组(27.3%比 26.2%;p=0.02)有所下降。所有三组感染预防和控制专业人员的医护比例都有所提高。
代表性组的 NI 和 AU 患病率下降,而其他分析组的结果则喜忧参半。显然,还需要进一步努力减少 NI 和 ABA。