Associations between nosocomial meticillin-resistant Staphylococcus aureus and nosocomial Clostridium difficile-associated diarrhoea in 89 German hospitals
Associations between nosocomial meticillin-resistant Staphylococcus aureus and nosocomial Clostridium difficile-associated diarrhoea in 89 German hospitals
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DOI：
10.1016/j.jhin.2012.07.022
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发表时间：
2012-11-01
影响因子：
6.9
通讯作者：
Schwab, F.
中科院分区：
文献类型：
--
作者：
Meyer, E.;Gastmeier, P.;Schwab, F.
目的：量化和比较德国医院网络中医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)和艰难梭菌相关感染(CDI)的发病率密度；评估医院内MRSA与院内CDI之间是否存在关联。方法：急诊医院向德国医院感染监测系统(KISS)报告患者数量、住院天数和MRSA和/或CDI病例的数据。病例分为院内感染和输入性感染。用Spearman相关指数计算医院内MRSA和CDI的发病率和发病密度。结果：2010年医院共报告全院MRSA和CDI病例。分析包括1,536,031例患者，11,138,496人日，5183例医院内CDI病例和2233例医院内MRSA病例。医院内CDI的混合发病密度为0.47，是医院内MRSA(0.20)的两倍多。耐甲氧西林金黄色葡萄球菌与CDI的医院发生率之间的相关性有统计学意义[相关系数(CC)为0.515]。发病密度的相关性同样显著，CC为0.484。结论：在我们的数据库和所用定义中，医院内CDI的发病率是医院内MRSA发病率的两倍。医院内高MRSA或CDI病例可能是感染控制和/或抗生素选择压力不足的指标。(C)2012年医疗感染学会。爱思唯尔有限公司出版。保留所有权利。
Background: Clostridium difficile is mainly considered as a hospital-acquired pathogen causing diarrhoea in healthcare settings.Aim: To quantify and compare the incidence density of hospital-acquired meticillin-resistant Staphylococcus aureus (MRSA) and C. difficile-associated infection (CDI) in a network of German hospitals; also to assess whether there is an association between nosocomial MRSA and nosocomial CDI.Methods: Acute hospitals reported data on the number of patients, patient-days and MRSA and/or CDI cases to the German nosocomial infection surveillance system (KISS). Cases were classified as nosocomial or imported. Nosocomial incidences and incidence densities (per 1000 patient-days) of MRSA and CDI were calculated by Spearman correlation index.Results: In 2010, a total of 89 hospitals reported hospital-wide MRSA and CDI cases. The analysis included 1,536,031 patients, 11,138,496 patient-days, 5183 nosocomial CDI cases and 2233 nosocomial MRSA cases. The pooled incidence density of nosocomial CDI was 0.47, more than two-fold higher than that of nosocomial MRSA (0.20). Correlation of nosocomial incidences of MRSA and CDI was statistically significant [correlation coefficient (CC) of 0.515]. Correlation of incidence densities was likewise significant with a CC of 0.484.Conclusions: The incidence of nosocomial CDI was twice as high as nosocomial MRSA incidence among our database and with the definitions used. High nosocomial MRSA or CDI cases might be indicators for deficits in infection control and/or selection pressure of antibiotics. (C) 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.