背景:导管相关尿路感染(CAUTIs)占医疗保健相关感染的很大比例,并对发病率产生重大影响,住院时间,和死亡率。坚持推荐的感染预防措施可以有效降低CAUTI的发生率。本研究旨在评估各种规模医院的CAUTI特征和预防计划的有效性。
方法:干预计划,包括培训,监视,和监测,已实施。有关导致CAUTI的微生物的数据,导尿管利用率,每1000个设备天的CAUTI率,收集了2017年至2019年与留置导管使用相关的因素。在大学医院和中小型医院之间比较了CAUTI的发生率和相关数据。
结果:32家医院参与了这项研究,包括21所大学医院和11所中小型医院。引起CAUTI的微生物及其耐药率在两组之间没有差异。2018年第一季度,大学医院的发病率为2.05感染/1,000设备日,中小型医院的发病率为1.44感染/1,000设备日。在实施干预措施后,率在2019年一季度逐步下降,大学医院为1.18例感染/1000个设备日,中小型医院为0.79例感染/1000个设备日。然而,在研究结束时,大学医院的感染率增加到1.74感染/1,000个设备日,中小型医院的感染率增加到1.80感染/1,000个设备日。
结论:我们实施干预措施以预防CAUTI并评估其结果。当存在足够的支持和人员时,这些感染的发生率在干预的初始阶段降低。这些感染率可以通过实施积极的干预措施来降低,例如一致的监测和遵守预防感染的指南。
BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes.
METHODS: Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals.
RESULTS: Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals.
CONCLUSIONS: We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.