Abstract：
BACKGROUND: Invasive device-associated nosocomial infections commonly occur in intensive care units (ICUs). These infections include intravascular catheter-related bloodstream infection (CRBSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). This study aimed to evaluate the factors associated with invasive device-associated nosocomial infections based on the underlying diseases of the patients and antibiotic resistance profiles of the pathogens causing the infections detected in the ICU in our hospital over a five-year period.
METHODS: Invasive device-associated infections (CRBSI, VAP, and CAUTI) were detected retrospectively by the laboratory- and clinic-based active surveillance system according to the criteria of the US Centers for Disease Control and Prevention (CDC) in patients hospitalized in the ICU of the tertiary hospital between 1 January 2018 and 30 June 2023.
RESULTS: A total of 425 invasive device-associated nosocomial infections and 441 culture results were detected (179 CRBSI, 176 VAP, 70 CAUTI). Out of them, 57 (13.4%) patients had hematological malignancy, 145 (34.1%) had solid organ malignancy, and 223 (52.5%) had no histopathologic diagnosis of any malignancy. An increase in extended-spectrum beta lactamase (ESBL) and carbapenem resistance in pathogens was detected during the study period.
CONCLUSIONS: Antibiotic resistance of the Gram-negative bacteria associated with invasive device-associated infections increased during the study period. Antimicrobial stewardship will reduce rates of nosocomial infections, reduce mortality, and shorten hospital stay. Long-term catheterization and unnecessary antibiotic use should be avoided.
METHODS: Invasive device-associated infections (CRBSI, VAP, and CAUTI) were detected retrospectively by the laboratory- and clinic-based active surveillance system according to the criteria of the US Centers for Disease Control and Prevention (CDC) in patients hospitalized in the ICU of the tertiary hospital between 1 January 2018 and 30 June 2023.
RESULTS: A total of 425 invasive device-associated nosocomial infections and 441 culture results were detected (179 CRBSI, 176 VAP, 70 CAUTI). Out of them, 57 (13.4%) patients had hematological malignancy, 145 (34.1%) had solid organ malignancy, and 223 (52.5%) had no histopathologic diagnosis of any malignancy. An increase in extended-spectrum beta lactamase (ESBL) and carbapenem resistance in pathogens was detected during the study period.
CONCLUSIONS: Antibiotic resistance of the Gram-negative bacteria associated with invasive device-associated infections increased during the study period. Antimicrobial stewardship will reduce rates of nosocomial infections, reduce mortality, and shorten hospital stay. Long-term catheterization and unnecessary antibiotic use should be avoided.
摘要：
背景：与侵入性装置相关的医院感染通常发生在重症监护病房（ICU）中。这些感染包括血管内导管相关血流感染（CRBSI），呼吸机相关性肺炎(VAP),导管相关性尿路感染（CAUTI）。这项研究旨在评估与侵入性设备相关的医院感染相关的因素，这些因素是根据患者的潜在疾病以及在我们医院的ICU中发现的引起感染的病原体的抗生素耐药性来进行的。
方法：侵入性器械相关感染(CRBSI，VAP,和CAUTI）是根据美国疾病控制和预防中心（CDC）的标准，在2018年1月1日至2023年6月30日期间在三级医院ICU住院的患者中，通过基于实验室和临床的主动监测系统进行回顾性检测。
结果：共检测到425例侵入性器械相关医院感染和441例培养结果（179CRBSI，176VAP,70CAUTI).在他们当中,57例（13.4%）患者有恶性血液病，145（34.1％）患有实体器官恶性肿瘤，和223（52.5％）没有任何恶性肿瘤的组织病理学诊断。在研究期间，检测到病原体中超广谱β内酰胺酶（ESBL）和碳青霉烯耐药性的增加。
结论：在研究期间，与侵入性器械相关感染相关的革兰氏阴性菌的抗生素耐药性增加。抗菌药物管理将降低医院感染率，降低死亡率,缩短住院时间。应避免长期导管插入和不必要的抗生素使用。
方法：侵入性器械相关感染(CRBSI，VAP,和CAUTI）是根据美国疾病控制和预防中心（CDC）的标准，在2018年1月1日至2023年6月30日期间在三级医院ICU住院的患者中，通过基于实验室和临床的主动监测系统进行回顾性检测。
结果：共检测到425例侵入性器械相关医院感染和441例培养结果（179CRBSI，176VAP,70CAUTI).在他们当中,57例（13.4%）患者有恶性血液病，145（34.1％）患有实体器官恶性肿瘤，和223（52.5％）没有任何恶性肿瘤的组织病理学诊断。在研究期间，检测到病原体中超广谱β内酰胺酶（ESBL）和碳青霉烯耐药性的增加。
结论：在研究期间，与侵入性器械相关感染相关的革兰氏阴性菌的抗生素耐药性增加。抗菌药物管理将降低医院感染率，降低死亡率,缩短住院时间。应避免长期导管插入和不必要的抗生素使用。
