美国疾病控制与预防中心（CDC）关于 IV 级新生儿重症监护病房（NICU）与医疗保健相关的血流感染的定义的流行病学、危险因素和适用性。
Epidemiology, risk factors, and applicability of CDC definitions for healthcare-associated bloodstream infections at a level IV neonatal ICU.
机构信息
Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
Department of Pediatrics, Children's National Hospital, Washington, DC, USA.
出版信息
J Perinatol. 2023 Sep;43(9):1152-1157. doi: 10.1038/s41372-023-01728-y. Epub 2023 Aug 3.
OBJECTIVES
We studied the epidemiology of primary bloodstream infections (BSIs), secondary BSIs, and central line-associated BSIs (CLABSIs) and applicability of CDC definitions for primary sources of infection causing secondary BSIs in patients in the neonatal ICU.
STUDY DESIGN
We classified healthcare-associated BSIs (HABSIs) as primary BSIs, secondary BSIs, and CLABSIs using CDC surveillance definitions and determined their overall incidence and incidence among different gestational age strata. We assessed the applicability of CDC definitions for infection sources causing secondary BSIs.
RESULTS
From 2010 to 2019, 141 (32.7%), 202 (46.9%), and 88 (20.4%) HABSIs were classified as primary BSIs, secondary BSIs, and CLABSIs, respectively; all declined during the study period (all p < 0.001). Gestational age <28 weeks was associated with increased incidence of all HABSI types. CDC criteria for site-specific primary sources were met in 137/202 (68%) secondary BSIs.
CONCLUSIONS
Primary and secondary BSIs were more common than CLABSIs and should be prioritized for prevention.
目的
我们研究了新生儿重症监护病房（NICU）患者原发性血流感染（BSI）、继发性 BSI 和与中心静脉导管相关的 BSI（CLABSI）的流行病学，并评估了美国疾病预防与控制中心（CDC）对导致继发性 BSI 的原发性感染源的定义在这些患者中的适用性。
设计
我们使用 CDC 监测定义将医疗保健相关 BSI（HABSI）分类为原发性 BSI、继发性 BSI 和 CLABSI，并确定其总发生率和不同胎龄分层中的发生率。我们评估了 CDC 对导致继发性 BSI 的感染源的定义的适用性。
结果
2010 年至 2019 年，141 例（32.7%）、202 例（46.9%）和 88 例（20.4%）HABSI 分别被归类为原发性 BSI、继发性 BSI 和 CLABSI；所有这些在研究期间均呈下降趋势（均 P < 0.001）。胎龄 <28 周与所有 HABSI 类型的发生率增加相关。符合 CDC 特定部位原发性来源标准的继发性 BSI 为 137/202（68%）。
结论
原发性和继发性 BSI 比 CLABSI 更为常见，应优先预防。
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