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2011年至2022年韩国重症监护病房血流感染患者中微生物的发病率趋势:来自韩国国家医疗相关感染监测系统(KONIS)的数据。

Trends in incidence rates of micro-organisms among patients with bloodstream infections at intensive care units in South Korea from 2011 to 2022: data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS).

作者信息

Lee Y-M, Kim D Y, Kim E J, Park K-H, Lee M S

机构信息

Department of Infectious Diseases, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.

Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea.

出版信息

J Hosp Infect. 2025 Aug;162:197-206. doi: 10.1016/j.jhin.2025.04.037. Epub 2025 Jun 2.

Abstract

BACKGROUND

Trends in the microbiological distribution and incidence rates of multi-drug-resistant pathogens in patients with bloodstream infections (BSIs) in intensive care units (ICUs) were evaluated.

METHODS

This retrospective analysis was conducted using data from the Korean National Healthcare-Associated Infections Surveillance System. Annual trends in micro-organism distributions and multi-drug-resistant pathogens in patients with BSIs were investigated.

RESULTS

The incidence rate of BSI due to Staphylococcus aureus decreased from 33.1 per 100,000 patient-days in 2011 to 9.7 per 100,000 patient-days in 2022. The incidence rate of BSI due to Klebsiella pneumoniae increased from 6.4 per 100,000 patient-days in 2015 to 12.1 per 100,000 patient-days in 2022. The incidence rate of BSI due to meticillin-resistant S. aureus (MRSA) (28.8/100.000 patient-days in 2011; 7.3/100,000 patient-days in 2022) and the percentage of MRSA strains (91.8% in 2011; 76.7% in 2022) decreased throughout the study period. The incidence rate of BSI due to imipenem-resistant K. pneumoniae increased significantly from 0.3 per 100,000 patient-days in 2011 to 6.1 per 100,000 patient-days in 2021, and the percentage of imipenem-resistant K. pneumoniae strains increased from 4.3% in 2011 to 48.5% in 2022. The incidence rate of BSI due to imipenem-resistant Pseudomonas aeruginosa showed an increasing trend from 2011 to 2021.

CONCLUSION

The incidence rate of BSI due to MRSA in ICUs decreased, whereas the incidence rates of BSIs caused by imipenem-resistant K. pneumoniae and imipenem-resistant P. aeruginosa in ICUs showed an increasing trend. Over the past decades, there has been a significant shift from Gram-positive bacteria to Gram-negative bacteria in BSIs.

摘要

背景

评估重症监护病房(ICU)中血流感染(BSI)患者的微生物分布趋势及多重耐药病原体的发病率。

方法

本回顾性分析使用了韩国国家医疗相关感染监测系统的数据。调查了BSI患者中微生物分布和多重耐药病原体的年度趋势。

结果

金黄色葡萄球菌导致的BSI发病率从2011年的每10万患者日33.1例降至2022年的每10万患者日9.7例。肺炎克雷伯菌导致的BSI发病率从2015年的每10万患者日6.4例增至2022年的每10万患者日12.1例。耐甲氧西林金黄色葡萄球菌(MRSA)导致的BSI发病率(2011年为28.8/10万患者日;2022年为7.3/10万患者日)及MRSA菌株百分比(2011年为91.8%;2022年为76.7%)在整个研究期间均下降。耐亚胺培南肺炎克雷伯菌导致的BSI发病率从2011年的每10万患者日0.3例显著增至2021年的每10万患者日6.1例,耐亚胺培南肺炎克雷伯菌菌株百分比从2011年的4.3%增至2022年的48.5%。耐亚胺培南铜绿假单胞菌导致的BSI发病率在2011年至2021年呈上升趋势。

结论

ICU中MRSA导致的BSI发病率下降,而耐亚胺培南肺炎克雷伯菌和耐亚胺培南铜绿假单胞菌导致的BSI发病率呈上升趋势。在过去几十年中,BSI的病原体已从革兰氏阳性菌显著转向革兰氏阴性菌。

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