成人医疗保健相关感染相关的抗微生物药物耐药病原体：2015-2017 年向国家医疗保健安全网络报告的数据摘要。
Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015-2017.
机构信息
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
出版信息
Infect Control Hosp Epidemiol. 2020 Jan;41(1):1-18. doi: 10.1017/ice.2019.296. Epub 2019 Nov 26.
OBJECTIVE
Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015-2017 and were reported to the Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN).
METHODS
Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique.
RESULTS
Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards.
CONCLUSIONS
This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.
目的
描述 2015-2017 年期间向疾病控制与预防中心（CDC）的国家医疗保健安全网络（NHSN）报告的与医疗保健相关感染（HAI）相关的常见病原体和抗生素耐药模式。
方法
来自急性护理医院、长期急性护理医院和住院康复设施的中心静脉相关血流感染（CLABSI）、导管相关尿路感染（CAUTI）、呼吸机相关事件（VAE）和手术部位感染（SSI）的数据报告了设备相关 HAI。此分析包括从成人位置类型报告的设备相关 HAI 和≥18 岁患者的 SSI。计算了每种 HAI 类型、位置类型、手术类别和手术伤口闭合技术的选定抗生素不敏感率（%NS）。
结果
总体而言，在此期间，5626 家机构进行了成人 HAI 监测，其中大多数是<200 张病床的普通急性护理医院。大肠埃希菌（18%）、金黄色葡萄球菌（12%）和克雷伯菌属（9%）是报告最多的 3 种病原体。病原体因 HAI 和位置类型而异，与其他环境相比，肿瘤病房具有独特的病原体分布。与 SSI 相比，大多数病原体的%NS 在设备相关的 HAI 中明显更高。此外，来自长期急性护理医院的病原体的%NS 明显高于普通病房的病原体。
结论
本报告提供了一种按多种因素分层的特定 HAI 和病原体的病原体分布和抗生素耐药性的最新国家总结。这些数据强调了跟踪抗生素耐药性的重要性，特别是在长期急性护理医院和重症监护病房等弱势群体中。
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