Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran.
Department of Infectious Diseases, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Am J Infect Control. 2018 Jun;46(6):663-667. doi: 10.1016/j.ajic.2017.11.017. Epub 2018 Jan 9.
A national surveillance system for health care-associated infections (HAIs) in Iran is relatively new, and an update on incidence and mortality rates can aid clinicians and stakeholders in development of new guidelines and imperative modifications to be made.
Data were extracted from the national HAIs surveillance software for more than 7 million hospitalizations during 2015. Data regarding age, gender, deaths, ward of admission, and microbiologic findings were collected and analyzed.
From 491 hospitals, 7,018,393 hospitalizations were reported during 2015; 82,950 patients had been diagnosed with at least 1 HAI, 6,355 of whom died (crude fatality rate, 7.7). Men comprised 51.4% of the patients. The incidence rate was calculated to be 1.18. Urinary tract infections and pneumonia were the most commonly reported infections (27.9% and 23.8%) and 33% of patients were older than age 65 years. Intensive care units had the highest incidence rates, followed by burn units with incidence rates close to 9. Highest percentages of deaths were reported among patients with an HAI in the intensive care unit (20.6%) and those with pneumonia (39.6%).
Although the underreporting of HAIs hinders accurate calculation of incidence, the present study provides a general update. The results can help in modification of national guidelines and appropriate choice of antimicrobial agents in the management of HAIs.
在伊朗，一个新的全国性医疗保健相关性感染（HAI）监测系统正在运行，对发病率和死亡率进行更新可以帮助临床医生和利益相关者制定新的指南，并对必须进行的修改提供参考。
我们从 2015 年全国性 HAI 监测软件中提取了超过 700 万例住院患者的数据。收集并分析了年龄、性别、死亡、入院科室和微生物学发现等数据。
来自 491 家医院的数据显示，2015 年共报告了 7018393 例住院患者；82950 例患者至少被诊断为 1 种 HAI，其中 6355 例死亡（粗病死率为 7.7%）。男性占患者的 51.4%。发病率计算为 1.18%。尿路感染和肺炎是最常见的感染（分别占 27.9%和 23.8%），33%的患者年龄大于 65 岁。重症监护病房的发病率最高，其次是烧伤病房，发病率接近 9%。在重症监护病房发生 HAI 的患者（20.6%）和患有肺炎的患者（39.6%）的死亡率最高。
尽管 HAI 的漏报阻碍了发病率的准确计算，但本研究提供了一个总体更新。结果可以帮助修改国家指南，并在 HAI 的管理中选择适当的抗菌药物。
