2017-2020 年沙特阿拉伯某医院重症监护病房器械相关感染监测。
Surveillance of device associated infections in intensive care units at a Saudi Arabian Hospital, 2017-2020.
机构信息
Quality and Patient Safety Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA; Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Quality and Patient Safety Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
出版信息
J Infect Public Health. 2023 Jun;16(6):917-921. doi: 10.1016/j.jiph.2023.04.007. Epub 2023 Apr 12.
BACKGROUND
Device-associated infections (DAIs) are important components of healthcare associated infection and are associated with increased morbidity and mortality. This study describes DAIs across different intensive care units (ICUs) in a hospital in Saudi Arabia.
METHODS
The study was conducted between 2017 and 2020 and followed the definitions of National Healthcare Safety Network (NHSN) for DAIs. The calculated the rates of ventilator-associated events (VAE), catheter-associated urinary tract infections (CAUTI) and central line-associated blood stream infections (CLABSI) followed NHSN definitions.
RESULTS
During the study period, there were 82 DAIs in adult ICUs and of these 16 (19.5%) were CLABSI, 26 (31.7%) were CAUTI and 40 (48.7%) were VAE. The overall rates for adult ICUs were 1.6, 1.9, 3.8 per 1000 device-days for CAUTI, CLABSI and VAE, respectively. The device-utilization ratio was 0.5, 0.6, and 0.48 for urinary catheters, central lines, and ventilators, respectively. VAE rates for medical and surgical ICU were about 2.8 times the rate in the coronary care unit and the rates were high in 2020 corresponding with the COVID-19 pandemic. Of the adult ICUS, medical ICU had a CLABSI rate of 2.13/1000 device-days and was about double the rate in surgical and cardiac ICU. For CAUTI, the rates per 1000 device-days were 2.19, 1.73, and 1.65 for medical, surgical, and coronary ICUs, respectively. The rate of CLABSI per 1000 device-days for pediatric and neonatal ICUs were 3.38 and 2.28, respectively.
CONCLUSIONS
CAUTI was the most common infections among adult ICUs and medical ICU had higher rates than other adult ICUs. VAE rate was higher in the first year of the COVID-19 pandemic, indicating increased device-use, change in patients characteristics as well as possible change in practices across the ICUs.
背景
器械相关感染（DAI）是医疗保健相关感染的重要组成部分，与发病率和死亡率的增加有关。本研究描述了沙特阿拉伯一家医院不同重症监护病房（ICU）的 DAI。
方法
该研究于 2017 年至 2020 年进行，遵循国家医疗保健安全网络（NHSN）对 DAI 的定义。根据 NHSN 定义，计算了呼吸机相关事件（VAE）、导管相关尿路感染（CAUTI）和中心静脉置管相关血流感染（CLABSI）的发生率。
结果
在研究期间，成人 ICU 共发生 82 例 DAI，其中 16 例（19.5%）为 CLABSI，26 例（31.7%）为 CAUTI，40 例（48.7%）为 VAE。成人 ICU 的总体发生率分别为每 1000 个器械日 CAUTI、CLABSI 和 VAE 为 1.6、1.9 和 3.8。导尿管、中心静脉导管和呼吸机的器械使用率分别为 0.5、0.6 和 0.48。内科和外科 ICU 的 VAE 发生率是冠心病监护病房的 2.8 倍，2020 年 COVID-19 大流行期间发生率较高。在成人 ICU 中，内科 ICU 的 CLABSI 发生率为每 1000 个器械日 2.13，是外科和心脏内科 ICU 的两倍。对于 CAUTI，每 1000 个器械日的发生率分别为内科、外科和冠心病 ICU 为 2.19、1.73 和 1.65。儿科和新生儿 ICU 的 CLABSI 发生率分别为每 1000 个器械日 3.38 和 2.28。
结论
CAUTI 是成人 ICU 中最常见的感染，内科 ICU 的发生率高于其他成人 ICU。COVID-19 大流行的第一年 VAE 发生率较高，表明器械使用增加，患者特征发生变化，以及 ICU 实践可能发生变化。
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