Novosad Shannon A, Fike Lucy, Dudeck Margaret A, Allen-Bridson Katherine, Edwards Jonathan R, Edens Chris, Sinkowitz-Cochran Ronda, Powell Krista, Kuhar David
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
Infect Control Hosp Epidemiol. 2020 Mar;41(3):313-319. doi: 10.1017/ice.2019.303. Epub 2020 Jan 9.
To describe pathogen distribution and rates for central-line-associated bloodstream infections (CLABSIs) from different acute-care locations during 2011-2017 to inform prevention efforts.
CLABSI data from the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) were analyzed. Percentages and pooled mean incidence density rates were calculated for a variety of pathogens and stratified by acute-care location groups (adult intensive care units [ICUs], pediatric ICUs [PICUs], adult wards, pediatric wards, and oncology wards).
From 2011 to 2017, 136,264 CLABSIs were reported to the NHSN by adult and pediatric acute-care locations; adult ICUs and wards reported the most CLABSIs: 59,461 (44%) and 40,763 (30%), respectively. In 2017, the most common pathogens were Candida spp/yeast in adult ICUs (27%) and Enterobacteriaceae in adult wards, pediatric wards, oncology wards, and PICUs (23%-31%). Most pathogen-specific CLABSI rates decreased over time, excepting Candida spp/yeast in adult ICUs and Enterobacteriaceae in oncology wards, which increased, and Staphylococcus aureus rates in pediatric locations, which did not change.
The pathogens associated with CLABSIs differ across acute-care location groups. Learning how pathogen-targeted prevention efforts could augment current prevention strategies, such as strategies aimed at preventing Candida spp/yeast and Enterobacteriaceae CLABSIs, might further reduce national rates.
描述2011 - 2017年不同急症护理场所中心静脉导管相关血流感染（CLABSI）的病原体分布及发生率，为预防工作提供依据。
分析疾病控制与预防中心（CDC）国家医疗安全网络（NHSN）的CLABSI数据。计算各种病原体的百分比和合并平均发病率密度，并按急症护理场所组（成人重症监护病房[ICU]、儿科ICU[PICU]、成人病房、儿科病房和肿瘤科病房）进行分层。
2011年至2017年，成人和儿科急症护理场所向NHSN报告了136,264例CLABSI；成人ICU和病房报告的CLABSI最多，分别为59,461例（44%）和40,763例（30%）。2017年，成人ICU中最常见的病原体是念珠菌属/酵母菌（27%），而成人病房、儿科病房、肿瘤科病房和PICU中最常见的病原体是肠杆菌科（23% - 31%）。除成人ICU中的念珠菌属/酵母菌和肿瘤科病房中的肠杆菌科有所增加，以及儿科场所中的金黄色葡萄球菌发生率未变化外，大多数病原体特异性CLABSI发生率随时间下降。
不同急症护理场所组中与CLABSI相关的病原体存在差异。了解针对病原体的预防措施如何增强当前的预防策略，如预防念珠菌属/酵母菌和肠杆菌科CLABSI的策略，可能会进一步降低全国发病率。
