International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009
International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004-2009
复制标题
DOI：
10.1016/j.ajic.2011.05.020
复制
发表时间：
2012-06-01
影响因子：
4.9
通讯作者：
Jayatilleke, Kushlani
中科院分区：
文献类型：
--
作者：
Rosenthal, Victor D.;Hu Bijie;Jayatilleke, Kushlani
国际医院感染控制联盟（INICC）从2004年1月至2009年12月在拉丁美洲、亚洲、非洲和欧洲36个国家的422个重症监护病房（ICU）进行的监测研究结果报告。在为期6年的研究期间，使用疾病控制和预防中心（CDC）国家医疗安全网络（NHSN;前身为国家医院感染监测系统[NNIS]）对器械相关医疗保健相关感染的定义，我们收集了在联盟ICU住院的313，008例患者的前瞻性数据，总计2，194，897个ICU床位。尽管发展中国家ICU中器械的使用与CDC NHSN中美国ICU中报告的器械使用非常相似，但INICC医院ICU中器械相关的医院感染率显著更高; INICC ICU中心静脉导管相关血流感染的合并发生率为6.8/1，000个中心线-日比可比美国ICU中报告的2.0/1，000个中心线-日高3倍以上。呼吸机相关性肺炎的总体发生率也高得多（15.8 vs 3.3/1000呼吸机日），导管相关性尿路感染的发生率也高得多（6.3 vs 3.3/1000导管日）。值得注意的是，铜绿假单胞菌分离株对亚胺培南的耐药频率肺炎克雷伯菌分离株对头孢他啶耐药率分别为47.2%和23.0%（76.3% vs 27.1%），大肠埃希菌分离株对头孢他啶耐药（66.7% vs 8.1%），金黄色葡萄球菌分离株对甲氧西林敏感（84.4%对56.8%），在联盟的ICU中也更高，器械相关感染的粗未调整超额死亡率为7.3%（导管相关尿路感染）至15.2%（呼吸机相关肺炎）。版权所有（C）2011由感染控制和流行病学专业人员协会，Inc.爱思唯尔公司出版All rights reserved.
The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright (C) 2011 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.