某大学医院医疗相关感染的5年监测：一项回顾性分析。
A 5-year surveillance of healthcare-associated infections in a university hospital: A retrospective analysis.
作者信息
Erdem Ilknur, Yıldırım Ilker, Safak Birol, Karaali Ritvan, Erdal Berna, Ardic Enes, Dogan Mustafa, Kardan M Enes, Kavak Caglar, Sahin Karadil Kubra, Yildiz Emre, Topcu Birol, Kiraz Nuri, Arar Cavidan
机构信息
Department of Infectious Diseases, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey.
Department of Anesthesiology and Reanimation, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey.
出版信息
SAGE Open Med. 2022 Apr 19;10:20503121221091789. doi: 10.1177/20503121221091789. eCollection 2022.
OBJECTIVES
"Nosocomial infections" or "healthcare-associated infections" are a significant public health problem around the world. This study aimed to assess the rate of laboratory-confirmed healthcare-associated infections, frequency of nosocomial pathogens, and the antimicrobial resistance patterns of bacterial isolates in a University Hospital.
METHODS
A retrospective evaluation of healthcare-associated infections in a University Hospital, between the years 2015 and 2019 in Tekirdag, Turkey.
RESULTS
During the 5 years, the incidence densities of healthcare-associated infections in intensive care units and clinics were 10.31 and 1.70/1000 patient-days, respectively. The rates of ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections in intensive care units were 11.57, 4.02, and 1.99 per 1000 device-days, respectively. The most common healthcare-associated infections according to the primary sites were bloodstream infections (55.3%) and pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram-negative bacteria, 24.9% of Gram-positive bacteria, and 7.6% of . The most frequently isolated causative agents were (16.7%) and (15.7%). The rate of extended-spectrum beta-lactamase production among isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of , 95.1% among isolates of , and 18.2% among isolates of . Colistin resistance was 2.4% among isolates of . Vancomycin resistance was 5.3% among isolates of
CONCLUSION
Our study results demonstrate that healthcare-associated infections are predominantly originated by intensive care units. The microorganisms isolated from intensive care units are highly resistant to many antimicrobial agents. The rising incidence of multidrug-resistant microorganisms indicates that more interventions are urgently needed to reduce healthcare-associated infections in our intensive care units.
目的
“医院感染”或“医疗保健相关感染”是全球一个重大的公共卫生问题。本研究旨在评估一所大学医院中实验室确诊的医疗保健相关感染率、医院病原体的频率以及细菌分离株的抗菌药物耐药模式。
方法
对土耳其泰基尔达一所大学医院2015年至2019年期间的医疗保健相关感染进行回顾性评估。
结果
在这5年期间，重症监护病房和诊所的医疗保健相关感染发病密度分别为每1000患者日10.31例和1.70例。重症监护病房中呼吸机相关性肺炎、中心静脉导管相关血流感染和导尿管相关尿路感染的发生率分别为每1000器械日11.57例、4.02例和1.99例。根据主要感染部位，最常见的医疗保健相关感染是血流感染（55.3%）和肺炎（20.4%）。作为医院病原体分离出的微生物中，67.5%为革兰氏阴性菌，24.9%为革兰氏阳性菌，7.6%为……。最常分离出的病原体是……（16.7%）和……（15.7%）。在……分离株中，超广谱β-内酰胺酶产生率为51.1%。在……分离株中，碳青霉烯类耐药率为29.8%，在……分离株中为95.1%，在……分离株中为18.2%。在……分离株中，黏菌素耐药率为2.4%。在……分离株中，万古霉素耐药率为5.3%。
结论
我们的研究结果表明，医疗保健相关感染主要起源于重症监护病房。从重症监护病房分离出的微生物对许多抗菌药物具有高度耐药性。多重耐药微生物发病率的上升表明，迫切需要采取更多干预措施来减少我们重症监护病房中的医疗保健相关感染。
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