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国际医院感染控制联盟(INICC)关于医源性感染的报告,2015 年至 2020 年 45 个国家的数据摘要,成人和儿科病房,器械相关模块。

International Nosocomial Infection Control Consortium (INICC) report of health care associated infections, data summary of 45 countries for 2015 to 2020, adult and pediatric units, device-associated module.

机构信息

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA; Department of Infection Prevention, INICC Foundation, International Nosocomial Infection Control Consortium, Miami, USA.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA.

出版信息

Am J Infect Control. 2024 Sep;52(9):1002-1011. doi: 10.1016/j.ajic.2023.12.019. Epub 2024 Jan 6.

Abstract

BACKGROUND

Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East.

METHODS

Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI).

RESULTS

We gathered data from 204,770 patients, 1,480,620 patient days, 936,976 central line (CL)-days, 637,850 mechanical ventilators (MV)-days, and 1,005,589 urinary catheter (UC)-days. Our results showed 4,270 CL-associated bloodstream infections, 7,635 ventilator-associated pneumonia, and 3,005 UC-associated urinary tract infections. The combined rates of DA-HAIs were 7.28%, and 10.07 DA-HAIs per 1,000 patient days. CL-associated bloodstream infections occurred at 4.55 per 1,000 CL-days, ventilator-associated pneumonias at 11.96 per 1,000 MV-days, and UC-associated urinary tract infections at 2.91 per 1,000 UC days. In terms of resistance, Pseudomonas aeruginosa showed 50.73% resistance to imipenem, 44.99% to ceftazidime, 37.95% to ciprofloxacin, and 34.05% to amikacin. Meanwhile, Klebsiella spp had resistance rates of 48.29% to imipenem, 72.03% to ceftazidime, 61.78% to ciprofloxacin, and 40.32% to amikacin. Coagulase-negative Staphylococci and Staphylococcus aureus displayed oxacillin resistance in 81.33% and 53.83% of cases, respectively.

CONCLUSIONS

The high rates of DA-HAI and bacterial resistance emphasize the ongoing need for continued efforts to control them.

摘要

背景

报告 2015 年至 2020 年期间国际医院感染控制联合会研究结果,该研究在 45 个国家的 123 个城市的 630 个重症监护病房进行,涵盖了非洲、亚洲、东欧、拉丁美洲和中东地区。

方法

通过国际医院感染控制联合会监测在线系统收集前瞻性重症监护病房患者数据。采用疾病控制与预防中心/国家卫生保健安全网络的定义来确定器械相关的医疗保健相关感染(DA-HAI)。

结果

我们收集了 204770 名患者、1480620 个患者日、936976 个中心静脉置管(CL)日、637850 个机械通气(MV)日和 1005589 个导尿管(UC)日的数据。结果显示,有 4270 例 CL 相关血流感染、7635 例呼吸机相关性肺炎和 3005 例 UC 相关尿路感染。DA-HAI 的综合发生率为 7.28%,每 1000 个患者日发生 10.07 例 DA-HAI。CL 相关血流感染的发生率为每 1000CL 日 4.55 例,呼吸机相关性肺炎为每 1000MV 日 11.96 例,UC 相关尿路感染为每 1000UC 日 2.91 例。在耐药性方面,铜绿假单胞菌对亚胺培南的耐药率为 50.73%,头孢他啶为 44.99%,环丙沙星为 37.95%,阿米卡星为 34.05%。同时,克雷伯氏菌属对亚胺培南的耐药率为 48.29%,头孢他啶为 72.03%,环丙沙星为 61.78%,阿米卡星为 40.32%。凝固酶阴性葡萄球菌和金黄色葡萄球菌的耐苯唑西林率分别为 81.33%和 53.83%。

结论

高 DA-HAI 和细菌耐药率强调了持续努力控制这些感染的必要性。

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