Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007
Antimicrobial-Resistant Pathogens Associated With Healthcare-Associated Infections: Annual Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007
复制标题
DOI：
10.1086/591861
复制
发表时间：
2008-11-01
影响因子：
4.5
通讯作者：
Fridkin, Scott K.
中科院分区：
文献类型：
--
作者：
Hidron, Alicia I.;Edwards, Jonathan R.;Fridkin, Scott K.
目标。描述国家医疗安全网络(NHSN)中医院报告的引起设备相关和操作相关医疗保健相关感染(HAI)的病原体中选定的抗菌素耐药模式的频率。方法：包括2006年1月至2007年10月期间向NHSN患者安全部分报告的HAI的数据(即，中心线相关的血流感染、导管相关的尿路感染、呼吸机相关肺炎和手术部位感染)。对某医院每HAI最多3株病原菌的药敏试验结果进行评估，以确定病原菌的耐药性。根据HAI的类型和总体计算被解释为对所选抗菌剂具有耐药性的病原菌的汇集平均比例。结果：总体上，463家医院报告了1个或更多HAI：412个(89%)是普通急诊医院，309个(67%)有200-1000个床位。在25,384名患者中，报告了28,502例血吸虫病。前10位病原菌为凝固酶阴性葡萄球菌(15%)、金黄色葡萄球菌(15%)、肠球菌(12%)、念珠菌(11%)、大肠埃希菌(10%)、铜绿假单胞菌(8%)、肺炎克雷伯菌(6%)、肠杆菌(5%)、鲍曼不动杆菌(3%)和产酸克雷伯菌(2%)。对于某些病原体-抗菌药物组合，不同类型的HAI的病原菌耐药的平均比例有很大差异。在所有HAI中，多达16%与以下多重耐药病原体有关：甲氧西林耐药金黄色葡萄球菌(8%)、万古霉素耐药屎肠球菌(4%)、碳青霉烯耐药铜绿假单胞菌(2%)、超广谱头孢菌素耐药肺炎克雷伯菌(1%)、超广谱头孢菌素耐药大肠埃希菌(0.5%)、耐碳青霉烯类鲍曼不动杆菌、肺炎克雷伯菌、产酸克雷伯菌和大肠杆菌(0.5%)。在全国范围内，大多数单位报告说，由于这些耐药病原体，没有人感染禽流感。
OBJECTIVE. To describe the frequency of selected antimicrobial resistance patterns among pathogens causing device-associated and procedure-associated healthcare-associated infections (HAIs) reported by hospitals in the National Healthcare Safety Network (NHSN).METHODS. Data are included on HAIs (ie, central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia, and surgical site infections) reported to the Patient Safety Component of the NHSN between January 2006 and October 2007. The results of antimicrobial susceptibility testing of up to 3 pathogenic isolates per HAI by a hospital were evaluated to define antimicrobial-resistance in the pathogenic isolates. The pooled mean proportions of pathogenic isolates interpreted as resistant to selected antimicrobial agents were calculated by type of HAI and overall. The incidence rates of specific device-associated infections were calculated for selected antimicrobial-resistant pathogens according to type of patient care area; the variability in the reported rates is described.RESULTS. Overall, 463 hospitals reported 1 or more HAIs: 412 (89%) were general acute care hospitals, and 309 (67%) had 200-1,000 beds. There were 28,502 HAIs reported among 25,384 patients. The 10 most common pathogens (accounting for 84% of any HAIs) were coagulase-negative staphylococci (15%), Staphylococcus aureus ( 15%), Enterococcus species (12%), Candida species (11%), Escherichia coli (10%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (6%), Enterobacter species (5%), Acinetobacter baumannii (3%), and Klebsiella oxytoca (2%). The pooled mean proportion of pathogenic isolates resistant to antimicrobial agents varied significantly across types of HAI for some pathogen-antimicrobial combinations. As many as 16% of all HAIs were associated with the following multidrug- resistant pathogens: methicillin-resistant S. aureus (8% of HAIs), vancomycin-resistant Enterococcus faecium (4%), carbapenem-resistant P. aeruginosa (2%), extended-spectrum cephalosporin-resistant K. pneumoniae (1%), extended-spectrum cephalosporin-resistant E. coli (0.5%), and carbapenem-resistant A. baumannii, K. pneumoniae, K. oxytoca, and E. coli (0.5%). Nationwide, the majority of units reported no HAIs due to these antimicrobial-resistant pathogens.