Lim Lyn-Li, Lim Kang Wei Esther, Malloy Michael J, Bull Ann, Brett Judith, Worth Leon J
Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, Australia.
Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
Infect Control Hosp Epidemiol. 2024 Nov 7:1-7. doi: 10.1017/ice.2024.132.
We aimed to describe the incidence, pathogens, and antimicrobial susceptibility of central line-associated bloodstream infections (CLABSI) in adult intensive care units (ICU).
State surveillance data from 2011 to 2022 were analyzed to identify patient and device days and CLABSI events. Pathogen data were analyzed to determine the most common organisms and patterns of antimicrobial resistance grouped into 3-year time epochs.
Adult ICU in Victoria, Australia.
Healthcare organizations participating in CLABSI state surveillance.
608 events were reported over 751,350 device days. Overall, CLABSI incidence was 0.81 per 1,000 central-line days, with a 49.3% rate reduction from 2011 to 2022 (1.39 to 0.70 per 1,000 central-line days). Overall device utilization ratio was 0.57, with a 15.4% reduction from 2011 to 2022 (0.67 vs 0.56). Of 690 pathogens, the most common by rank order were coagulase-negative Staphylococci (CNS), species, , and . The proportion of CNS-causing events increased by 69.0% from 2011 to 2022; this trend was not observed for other organisms. For every increase in epoch, a 33% decrease in methicillin-resistant (MRSA), 4% increase in vancomycin-resistant , and 12% increase in ceftriaxone-resistant pathogens were observed.
We demonstrate a decreasing incidence of CLABSI in Victorian adult ICU and an increasing burden of infections due to CNS. No significant time trend increases in antimicrobial-resistant organisms, including MRSA, vancomycin-resistant , and ceftriaxone-resistant were observed. These findings are relevant for identifying priorities for CLABSI prevention in Victorian adult ICU.
我们旨在描述成人重症监护病房（ICU）中心静脉导管相关血流感染（CLABSI）的发病率、病原体及抗菌药物敏感性。
分析2011年至2022年的国家监测数据，以确定患者和设备使用天数以及CLABSI事件。分析病原体数据，以确定最常见的微生物以及按3年时间跨度分组的抗菌药物耐药模式。
澳大利亚维多利亚州的成人ICU。
参与CLABSI国家监测的医疗机构。
在751350个设备使用日期间报告了608起事件。总体而言，CLABSI发病率为每1000个中心静脉导管日0.81例，从2011年到2022年下降了49.3%（从每1000个中心静脉导管日1.39例降至0.70例）。总体设备使用率为0.57，从2011年到2022年下降了15.4%（从0.67降至0.56）。在690种病原体中，按排名顺序最常见的是凝固酶阴性葡萄球菌（CNS）、[具体菌种1]、[具体菌种2]和[具体菌种3]。从2011年到2022年，由CNS引起的事件比例增加了69.0%；其他微生物未观察到这种趋势。每增加一个时间跨度，耐甲氧西林[具体菌种]（MRSA）减少33%，耐万古霉素[具体菌种]增加4%，耐头孢曲松[具体菌种]增加12%。
我们证明了维多利亚州成人ICU中CLABSI的发病率在下降，而CNS引起的感染负担在增加。未观察到包括MRSA、耐万古霉素[具体菌种]和耐头孢曲松[具体菌种]在内的抗菌药物耐药微生物有显著的时间趋势增加。这些发现对于确定维多利亚州成人ICU中CLABSI预防的重点具有重要意义。
