Department of Infection Control, West China Hospital, Sichuan University, Chengdu, China.
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
Clin Infect Dis. 2020 Dec 23;71(Suppl 4):S372-S378. doi: 10.1093/cid/ciaa1514.
More than 3 decades have passed since infection control was implemented nationwide in China in 1986. A comprehensive set of regulations and guidelines has been developed, and almost all hospitals have established infection control teams. However, compliance is variable and is usually suboptimal. The incidence of certain multidrug-resistant organisms (MDROs), including carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP), is increasing, and associated infections are mainly hospital-acquired in China. Carbapenem-resistant Pseudomonas aeruginosa has remained relatively stable, whereas methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterobacter faecium have been decreasing. The spread of CRAB and CRKP in China is largely mediated by dominant high-risk lineages, namely, clonal complex 92 for CRAB and sequence type 11 for CRKP. However, challenges owing to MDROs bring opportunities for rethinking, taking coordinated action, building capacity, changing behavior, and performing studies that reflect everyday situations in the Chinese healthcare system.
自 1986 年中国在全国范围内实施感染控制以来，已经过去了 30 多年。已经制定了一套全面的法规和指南，几乎所有医院都成立了感染控制团队。然而，合规性是可变的，通常并不理想。某些多药耐药菌（MDRO）的发病率在增加，包括耐碳青霉烯鲍曼不动杆菌（CRAB）和耐碳青霉烯肺炎克雷伯菌（CRKP）在中国，这些相关感染主要是医院获得性的。耐碳青霉烯铜绿假单胞菌相对稳定，而耐甲氧西林金黄色葡萄球菌和万古霉素耐药肠球菌则在减少。CRAB 和 CRKP 在我国的传播主要是由优势高风险谱系介导的，即耐碳青霉烯鲍曼不动杆菌的克隆复合体 92 和耐碳青霉烯肺炎克雷伯菌的序列类型 11。然而，MDRO 带来的挑战为重新思考、采取协调行动、建立能力、改变行为以及进行反映中国医疗体系日常情况的研究提供了机会。
