Unit 37: Nosocomial Infections, Surveillance of Antimicrobial Resistance and Consumption, Robert Koch Institute, Berlin, Germany.
Jena University Hospital, Institute of General Practice and Family Medicine, Jena, Germany.
Euro Surveill. 2021 Nov;26(45). doi: 10.2807/1560-7917.ES.2021.26.45.2001628.
BackgroundHospital-acquired infections (HAI) caused by spp., especially vancomycin-resistant (VRE), are of rising concern.AimWe summarised data on incidence, mortality and proportion of HAI caused by enterococci in the World Health Organization European Region.MethodsWe searched Medline and Embase for articles published between 1 January 2010 and 4 February 2020. Random-effects meta-analyses were performed to obtain pooled estimates.ResultsWe included 75 studies. spp. and VRE accounted for 10.9% (95% confidence interval (CI): 8.7-13.4; range: 6.1-17.5) and 1.1% (95% CI: 0.21-2.7; range: 0.39-2.0) of all pathogens isolated from patients with HAI. Hospital wide, the pooled incidence of HAI caused by spp. ranged between 0.7 and 24.8 cases per 1,000 patients (pooled estimate: 6.9; 95% CI: 0.76-19.0). In intensive care units (ICU), pooled incidence of HAI caused by spp. and VRE was 9.6 (95% CI: 6.3-13.5; range: 0.39-36.0) and 2.6 (95% CI: 0.53-5.8; range: 0-9.7). Hospital wide, the pooled vancomycin resistance proportion among spp. HAI isolates was 7.3% (95% CI: 1.5-16.3; range: 2.6-11.5). In ICU, this proportion was 11.5% (95% CI: 4.7-20.1; range: 0-40.0). Among patients with hospital-acquired bloodstream infections with spp., pooled all-cause mortality was 21.9% (95% CI: 15.7-28.9; range: 14.3-32.3); whereas all-cause mortality attributable to VRE was 33.5% (95% CI: 13.0-57.3; range: 14.3-41.3).ConclusionsInfections caused by spp. are frequently identified among hospital patients and associated with high mortality.
背景
由 spp. 引起的医院获得性感染（HAI），尤其是耐万古霉素的 （VRE），正受到越来越多的关注。
目的
我们总结了世界卫生组织欧洲区域关于肠球菌引起的 HAI 的发病率、死亡率和 HAI 构成比的数据。
方法
我们检索了 2010 年 1 月 1 日至 2020 年 2 月 4 日期间发表的 Medline 和 Embase 中的文章。采用随机效应荟萃分析来获取汇总估计值。
结果
我们纳入了 75 项研究。在 HAI 患者中分离的所有病原体中， spp. 和 VRE 分别占 10.9%（95%置信区间（CI）：8.7-13.4；范围：6.1-17.5）和 1.1%（95% CI：0.21-2.7；范围：0.39-2.0）。在整个医院中， spp. 引起的 HAI 的发病率范围为每 1000 名患者中有 0.7 至 24.8 例（汇总估计值：6.9；95% CI：0.76-19.0）。在重症监护病房（ICU）中， spp. 和 VRE 引起的 HAI 的发病率分别为 9.6（95% CI：6.3-13.5；范围：0.39-36.0）和 2.6（95% CI：0.53-5.8；范围：0-9.7）。在整个医院中， spp. HAI 分离株的万古霉素耐药率为 7.3%（95% CI：1.5-16.3；范围：2.6-11.5）。在 ICU 中，这一比例为 11.5%（95% CI：4.7-20.1；范围：0-40.0）。在患有 spp. 引起的医院获得性血流感染的患者中，全因死亡率的汇总估计值为 21.9%（95% CI：15.7-28.9；范围：14.3-32.3）；而 VRE 引起的全因死亡率为 33.5%（95% CI：13.0-57.3；范围：14.3-41.3）。
结论
在医院患者中经常发现 spp. 引起的感染，并且与高死亡率相关。
