Department of Laboratory, Guangdong Provincial People's Hospital and Guangdong Academy of Medicine Sciences, Guangzhou, China; Guangdong Nosocomial Infection Control and Quality Improvement Centre, Guangzhou, Guangdong, China.
Guangdong Nosocomial Infection Control and Quality Improvement Centre, Guangzhou, Guangdong, China; Department of Infection Prevention and Control, Guangdong Zhongshan City People's Hospital, Zhongshan, China.
Int J Infect Dis. 2019 Dec;89:179-184. doi: 10.1016/j.ijid.2019.09.021. Epub 2019 Sep 30.
Limited data on healthcare-associated infections (HAIs) are available from the developing world, thus a point prevalence survey was conducted to determine the prevalence of HAIs and antimicrobial use in Guangdong Province, China.
A standardized methodology for point prevalence surveys on HAIs and antimicrobial use has been developed by the Chinese Nosocomial Infection Control and Quality Improvement Center. The prevalence of HAIs, antimicrobial use, and baseline hospital-level variables were collected in 189 hospitals from June 2017 to May 2018.
Of 5 868 147 patients, 72 976 had one or more HAIs (1.24%), with 82 700 distinct HAIs. The prevalence rates of device-associated infections, including ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream infection were 7.92, 2.06, and 0.63 per 1000 catheter-days, respectively. A total of 10 591 (0.18%) HAIs caused by multidrug-resistant organisms were identified. Carbapenem non-susceptibility rates were highest in Acinetobacter species (53.86%) and Pseudomonas aeruginosa (21.60%). Forty-six percent (2 712 258/5 868 147) of inpatients were receiving at least one antimicrobial during this survey.
This survey indicated the relatively lower prevalence of HAIs but higher antimicrobial using in Guangdong Province compared with other mid to low-income and high-income countries. Further studies are warranted to elucidate which HAI-related indicators are the best measures of HAI performance and thus allow improvements leading to better patient outcomes.
发展中国家有关医疗保健相关性感染(HAIs)的数据有限,因此进行了一项现患率调查,以确定中国广东省的 HAI 患病率和抗菌药物使用情况。
中国医院感染控制与质量改进中心制定了 HAI 和抗菌药物使用现患率调查的标准化方法。2017 年 6 月至 2018 年 5 月,在 189 家医院收集了 HAI 患病率、抗菌药物使用情况和基线医院水平变量。
在 5868147 例患者中,72976 例(1.24%)发生了 1 次或多次 HAI,共有 82700 例不同的 HAI。器械相关性感染(包括呼吸机相关性肺炎、导管相关性尿路感染和中心静脉导管相关血流感染)的患病率分别为每 1000 个导管日 7.92、2.06 和 0.63。共发现 10591 例(0.18%)多药耐药菌引起的 HAI。耐碳青霉烯类药物的发生率在不动杆菌属(53.86%)和铜绿假单胞菌(21.60%)中最高。在本次调查期间,46%(2712258/5868147)的住院患者至少使用了一种抗菌药物。
与其他中低收入国家和高收入国家相比,本次调查显示广东省 HAI 的患病率相对较低,但抗菌药物使用率较高。需要进一步研究阐明哪些与 HAI 相关的指标是衡量 HAI 表现的最佳指标,从而可以采取改进措施,以改善患者预后。