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首页> 中文期刊> 《中国感染控制杂志》 >耐万古霉素肠球菌感染流行病学多中心研究

耐万古霉素肠球菌感染流行病学多中心研究

         
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目的：了解我国综合医院重症监护病房（ICU）耐万古霉素肠球菌（VRE）感染的流行特点，为感染预防和控制提供科学依据。方法以多中心研究的方式，选取全国12个省及直辖市46所医院，按照统一的诊断标准和方法，前瞻性调查2013年10月—2014年9月 ICU 住院患者 VRE 感染情况。结果共调查58个 ICU 住院患者33443例，检出感染／定植肠球菌936株，VRE 36株，VRE 检出率3．85％。VRE 医院发病的感染（HOI）26例次，VRE HOI 发病率0．78‰，VRE HOI 日发病率0．09‰。VRE 社区发病的感染（COI）9例次，VRE COI 发病率0．27‰。VRE 感染标本类型主要为尿（占42．86％），感染部位以及 HOI 部位均以泌尿道为主，分别为45．71％、50．00％。不同类型 ICU 以呼吸 ICU VRE 检出率（20．00％）、VRE HOI 发病率（8．04‰）和日发病率（0．47‰）最高；不同地区以西南地区 VRE 检出率（9．74％）、VRE HOI 发病率（3．68‰）、日发病率（0．35‰）最高。结论我国VRE 检出及感染发病率较低，不同 ICU、地区分布不同，应继续加强监测，根据感染特点指导临床抗菌药物使用及防控措施的落实。%Objective To investigate the epidemiological characteristics of vancomycin-resistant Enterococcus (VRE)infections in intensive care units (ICUs)of general hospitals in China,and provide scientific basis for infec-tion prevention and control.Methods A multicentre study was conducted,46 hospitals of 12 provinces and cities in China were studied,VRE infection in ICU patients who were hospitalized from October 2013 to September 2014 was investigated prospectively according to unified diagnostic criteria and methods.Results A total of 33 443 patients in 58 ICUs were included in study,936 infection/colonization Enterococcus strains were isolated,of which 36 (3.85%) were VRE.26 infection cases were hospital-onset infection(HOI)caused by VRE ,the incidence was 0.78‰,and 0.09/1 000 patient-days.Nine infection cases were VRE community-onset infection (COI),incidence was 0.27‰. The main type of VRE infection specimen was urine (42.86%),the main infection site and HOI site was urinary tract (45.71 %,50.00%,respectively).Of different ICUs,respiratory ICUs had the highest VRE isolation rate (20.00%),VRE HOI rate (8.04‰)and HOI incidence per 1 000 patient-days (0.47‰);Of different regions, southwest region had the highest VRE isolation rate (9.74%),VRE HOI rate (3.68‰)and HOI incidence per 1 000patient-days (0.35‰).Conclusion Isolation and infection rate of VRE in China are at low levels,but there are difference among different ICUs/regions,monitoring should be intensified continuously,rational use of antimicrobial agents and prevention and control measures should be implemented according to infection characteristics.

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