Rosenthal Victor Daniel, Duszynska Wieslawa, Ider Bat-Erdene, Gurskis Vaidotas, Al-Ruzzieh Majeda A, Myatra Sheila Nainan, Gupta Debkishore, Belkebir Souad, Upadhyay Namita, Zand Farid, Todi Subhash Kumar, Kharbanda Mohit, Nair Pravin K, Mishra Sanghamitra, Chaparro Gustavo, Mehta Yatin, Zala Dolatsinh, Janc Jaroslaw, Aguirre-Avalos Guadalupe, Aguilar-De-Morós Daisy, Hernandez-Chena Blanca Estela, Gün Emrah, Oztoprak-Cuvalci Nefise, Yildizdas Dincer, Abdelhalim Mona Moheyeldin, Ozturk-Deniz Suna Secil, Gan Chin Seng, Hung Nguyen Viet, Joudi Hala, Omar Abeer Aly, Gikas Achilleas, El-Kholy Amani Ali, Barkat Amina, Koirala Anjeela, Cerero-Gudiño Antonio, Bouziri Asma, Gomez-Nieto Katherine, Fisher Dale, Medeiros Eduardo A, Salgado-Yepez Estuardo, Horhat Florin, Agha Hala Mounir Moustafa, Vimercati Julio César, Villanueva Victoria, Jayatilleke Kushlani, Nguyet Le Thi Thu, Raka Lul, Miranda-Novales María Guadalupe, Petrov Michael Mihailov, Apisarnthanarak Anucha, Tayyab Nadia, Elahi Naheed, Mejia Nepomuceno, Morfin-Otero Rayo, Al-Khawaja Safa, Anguseva Tanja, Gupta Umesh, Belskii Vladislav A, Mat Wan Rahiza Wan, Chapeta-Parada Edwin Giovanny, Guanche-Garcell Humberto, Barahona-Guzmán Nayide, Mathew Anju, Raja Kavita, Pattnaik Saroj Kumar, Pandya Nirav, Poojary Aruna Ananda, Chawla Rajesh, Mahfouz Tahsine, Kanj Souha S, Mioljevic Vesna, Hlinkova Sona, Mrazova Mariana, Al-Abdely Hail M, Guclu Ertugrul, Ozgultekin Asu, Baytas Volkan, Tekin Recep, Yalçın Ata Nevzat, Erben Nurettin
International Nosocomial Infection Control Consortium, Ciudad Autonoma De Buenos Aires, Argentina.
Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland.
Am J Infect Control. 2021 Oct;49(10):1267-1274. doi: 10.1016/j.ajic.2021.04.077. Epub 2021 Apr 24.
We report the results of INICC surveillance study from 2013 to 2018, in 664 intensive care units (ICUs) in 133 cities, of 45 countries, from Latin-America, Europe, Africa, Eastern-Mediterranean, Southeast-Asia, and Western-Pacific.
Prospective data from patients hospitalized in ICUs were collected through INICC Surveillance Online System. CDC-NHSN definitions for device-associated healthcare-associated infection (DA-HAI) were applied.
We collected data from 428,847 patients, for an aggregate of 2,815,402 bed-days, 1,468,216 central line (CL)-days, 1,053,330 mechanical ventilator (MV)-days, 1,740,776 urinary catheter (UC)-days. We found 7,785 CL-associated bloodstream infections (CLAB), 12,085 ventilator-associated events (VAE), and 5,509 UC-associated urinary tract infections (CAUTI). Pooled DA-HAI rates were 5.91% and 9.01 DA-HAIs/1,000 bed-days. Pooled CLAB rate was 5.30/1,000 CL-days; VAE rate was 11.47/1,000 MV-days, and CAUTI rate was 3.16/1,000 UC-days. P aeruginosa was non-susceptible (NS) to imipenem in 52.72% of cases; to colistin in 10.38%; to ceftazidime in 50%; to ciprofloxacin in 40.28%; and to amikacin in 34.05%. Klebsiella spp was NS to imipenem in 49.16%; to ceftazidime in 78.01%; to ciprofloxacin in 66.26%; and to amikacin in 42.45%. coagulase-negative Staphylococci and S aureus were NS to oxacillin in 91.44% and 56.03%, respectively. Enterococcus spp was NS to vancomycin in 42.31% of the cases.
DA-HAI rates and bacterial resistance are high and continuous efforts are needed to reduce them.
我们报告了2013年至2018年在拉丁美洲、欧洲、非洲、东地中海、东南亚和西太平洋地区45个国家133个城市的664个重症监护病房（ICU）进行的INICC监测研究结果。
通过INICC在线监测系统收集ICU住院患者的前瞻性数据。采用美国疾病控制与预防中心国家医疗安全网络（CDC-NHSN）关于器械相关医疗相关感染（DA-HAI）的定义。
我们收集了428,847例患者的数据，总计2,815,402个床日、1,468,216个中心静脉导管（CL）日、1,053,330个机械通气（MV）日、1,740,776个导尿管（UC）日。我们发现7,785例中心静脉导管相关血流感染（CLAB）、12,085例呼吸机相关事件（VAE）和5,509例导尿管相关尿路感染（CAUTI）。合并的DA-HAI发生率为5.91%，每1000个床日发生9.01次DA-HAI。合并的CLAB发生率为每1000个CL日5.30例；VAE发生率为每1000个MV日11.47例，CAUTI发生率为每1000个UC日3.16例。铜绿假单胞菌对亚胺培南不敏感（NS）的病例占52.72%；对黏菌素不敏感的占10.38%；对头孢他啶不敏感的占50%；对环丙沙星不敏感的占40.28%；对阿米卡星不敏感的占34.05%。肺炎克雷伯菌对亚胺培南不敏感的占49.16%；对头孢他啶不敏感的占78.01%；对环丙沙星不敏感的占66.26%；对阿米卡星不敏感的占42.45%。凝固酶阴性葡萄球菌和金黄色葡萄球菌对苯唑西林不敏感的分别占91.44%和56.03%。肠球菌对万古霉素不敏感的病例占42.31%。
DA-HAI发生率和细菌耐药性较高，需要持续努力降低它们。
