How many infections are caused by patient-to-patient transmission in intensive care units?
How many infections are caused by patient-to-patient transmission in intensive care units?
复制标题
DOI：
10.1097/01.ccm.0000163223.26234.56
复制
发表时间：
2005-05-01
影响因子：
8.8
通讯作者：
Gastmeier, P
中科院分区：
文献类型：
--
作者：
Grundmann, H;B채rwolff, S;Gastmeier, P
目的：由于三级ICU患者之间的院内交叉传播导致的ICU获得性感染的比例尚不清楚。这些信息将是有用的实施适当的感染控制措施。设计：一个前瞻性队列研究，在18个月。来自两家大学医院的五个ICU。患者。所有患者入院时间>= 48小时。ICU获得性感染在每日床边患者和图表审查期间确定。通过对最常与ICU院内感染相关的10种细菌的所有临床和监测分离株进行高度鉴别性基因分型，确定了潜在交叉传播的发生。在两个或多个患者中分离出无法区分的分离株定义了潜在的传播事件。主要结果。在28，498个患者日期间，确定了431例ICU获得性感染和141例院内传播。共有278例感染是由基因分型的10个物种引起的，其中41例（14.5%）可能与患者之间的传播有关。在现代三级ICU治疗期间获得的感染很常见，但只有在常规微生物调查的基础上，才能确定其中少数感染的直接患者间传播的致病作用。
Objective: The proportion of intensive care unit (ICU)-acquired infections that are a consequence of nosocomial cross-transmission between patients in tertiary ICUs is unknown. Such information would be useful for the implementation of appropriate infection control measures.Design: A prospective cohort study during 18 months.Setting. Five ICUs from two university hospitals.Patients. All patients admitted for >= 48 hrs.Measurement. ICU-acquired infections were ascertained during daily bedside patient and chart reviews. Episodes of potential cross-transmission were identified by highly discriminating genetic typing of all clinical and surveillance isolates of the ten bacterial species most frequently associated with nosocomial infections in ICUs. Isolation of indistinguishable isolates in two or more patients defined potential transmission episodes.Main Results. During 28,498 patient days, 431 ICU-acquired infections and 141 episodes of nosocomial transmissions were identified. A total of 278 infections were caused by the ten species that were genotyped, and 41 of these (14.5%) could be associated with transmissions between patients.Conclusion. Infections acquired during treatment in modern tertiary ICUs are common, but a causative role of direct patient-to-patient transmission can only be ascertained for a minority of these infections on the basis of routine microbiological investigations.