Y Li1, X Cao2, H Ge1, Y Jiang3, H Zhou4, W Zheng4. 1. Department of Nosocomial Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China. 2. Department of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China. 3. Department of Nosocomial Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China. Electronic address: 155084141@qq.com. 4. Department of Nosocomial Infection Control, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, China.
Abstract
BACKGROUND: Nosocomial infections (NIs) impact care and costs in hospitals across the globe. There are few data on targeted surveillance of NI in intensive care units (ICUs), and data specific to the risk factors for NI are especially limited. METHODS: One hundred and seventy-six secondary and tertiary hospitals performed NI targeted surveillance in their ICUs. The data were collected and summarized by Minke software, then fed back once per quarter. FINDINGS: The incidence of NI appeared to decrease, and the incidence of NI per 1000 patient-days and adjusted incidence were 25.63‰ and 7.41‰ in 2010, and 9.73‰ and 2.76‰ in 2015, respectively. The NI incidence in general hospitals was higher than in specialized hospitals. The incidence of central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) appeared to decrease, and the incidence of ventilator-associated pneumonia (VAP) decreased markedly from 20.33‰ to 2.76‰. There was no statistically significant difference among ICUs. The six most frequently found pathogen-caused NIs were Acinetobacter baumannii (AB), Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA), Staphylococcus aureus, Candida albicans, and Escherichia coli (E. coli). The isolation rate of carbapenem-resistant Gram-negative bacilli were carbapenem-resistant AB 80.53%, carbapenem-resistant PA 39.94%, carbapenem-resistant KP (CRKP) 24.86%, and carbapenem-resistant E. coli 9.23%. The isolation rate of meticillin-resistant S. aureus (MRSA) was 66.30%. The increasing trend of CRKP was statistically significant as analysed by the regression model. CONCLUSION: The incidences of VAP, CAUTI, and CLABSI were high in ICUs, and multidrug-resistant organisms were the primary pathogens of NI. The implementation of targeted surveillance may determine the risk factors of NI so that effective intervention measures can be taken to reduce the incidence of NI in ICU patients.
BACKGROUND:Nosocomial infections (NIs) impact care and costs in hospitals across the globe. There are few data on targeted surveillance of NI in intensive care units (ICUs), and data specific to the risk factors for NI are especially limited. METHODS: One hundred and seventy-six secondary and tertiary hospitals performed NI targeted surveillance in their ICUs. The data were collected and summarized by Minke software, then fed back once per quarter. FINDINGS: The incidence of NI appeared to decrease, and the incidence of NI per 1000 patient-days and adjusted incidence were 25.63‰ and 7.41‰ in 2010, and 9.73‰ and 2.76‰ in 2015, respectively. The NI incidence in general hospitals was higher than in specialized hospitals. The incidence of central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) appeared to decrease, and the incidence of ventilator-associated pneumonia (VAP) decreased markedly from 20.33‰ to 2.76‰. There was no statistically significant difference among ICUs. The six most frequently found pathogen-caused NIs were Acinetobacter baumannii (AB), Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA), Staphylococcus aureus, Candida albicans, and Escherichia coli (E. coli). The isolation rate of carbapenem-resistant Gram-negative bacilli were carbapenem-resistant AB 80.53%, carbapenem-resistant PA 39.94%, carbapenem-resistant KP (CRKP) 24.86%, and carbapenem-resistant E. coli 9.23%. The isolation rate of meticillin-resistant S. aureus (MRSA) was 66.30%. The increasing trend of CRKP was statistically significant as analysed by the regression model. CONCLUSION: The incidences of VAP, CAUTI, and CLABSI were high in ICUs, and multidrug-resistant organisms were the primary pathogens of NI. The implementation of targeted surveillance may determine the risk factors of NI so that effective intervention measures can be taken to reduce the incidence of NI in ICU patients.
Authors: Cherry Lim; Elizabeth A Ashley; Raph L Hamers; Paul Turner; Thomas Kesteman; Samuel Akech; Alejandra Corso; Mayfong Mayxay; Iruka N Okeke; Direk Limmathurotsakul; H Rogier van Doorn Journal: Clin Microbiol Infect Date: 2021-06-07 Impact factor: 13.310