- 期刊
某醫學中心十年Acinetobacter baumannii院內感染在加護中心及普通病房流行病學變化
Acinetobacter baumannii Nosocomial Infection in Intensive Care Units and General Wards: Ten-year Retrospective Study in a Medical Center
摘要
Nosocomial infection caused by the fast emerging, highly transmissible organism, multidrug-resistant Acinetobacter baumannii (MDRAB) has become a global concern in the past decade. In this retrospective study, we analyzed all cases of nosocomial infection caused by A. baumannii since 1995 to 2004 in a medical center in Taipei, Taiwan The results showed that the mean infection density of A. baumannii nosocomial infection was 0.35‰. The infection density of A. baumannii nosocomial infection in intensive care units (ICU) was 8.45 times higher than that in general wards (P=0.001) The ranking in the frequency of infection sites were 33.8% in respiratory tract, 29.3% blood stream, and 17.1% urinary tract. Men had slightly higher rate of infection than women and proportion at 1.9:1. Sixty-six percent of patients were over 65 years old, and it showed no significant differences in sex arid age between ICU and general-ward patients The significant predisposing factors of general-ward patients were ma1gnancies, chronic obstructive pulmonary disease, and long-term bedridden status; and those for ICU patients were insertion of central venous catheter, Foley catheter, endotracheal tube, use of medical ventilator (ventilator-associated pneumonia were 77%), and total parenteral nutrition. In this study, 0-8% of A. baumannii nosocomial infections were imipenem-resistant. The rates of MDRAB were 4.5% in 1995, 70.9% in 2001 and 50% in 2004 The rates of A. baumannii resistant to all antibiotics routinely tested at this medical center were 0-0.8% between 1995 to 2001, and gradually increased from 2.2% in 2002, to 5.3% in 2004. The data showed that the rate of nosocomial infection due to A. baumannii was higher in ICU than in general wards and the predisposing factors of patients in these two areas were different: mainly invasive manipulations in ICU, versus under ling diseases in general wards However, the infection site was mostly respiratory tract. MDRAB should he considered as an important pathogen for nosocomial respiratory tract infection in ICU, particularly ventilator-associated pneumonia (VAP).
並列摘要
Nosocomial infection caused by the fast emerging, highly transmissible organism, multidrug-resistant Acinetobacter baumannii (MDRAB) has become a global concern in the past decade. In this retrospective study, we analyzed all cases of nosocomial infection caused by A. baumannii since 1995 to 2004 in a medical center in Taipei, Taiwan The results showed that the mean infection density of A. baumannii nosocomial infection was 0.35‰. The infection density of A. baumannii nosocomial infection in intensive care units (ICU) was 8.45 times higher than that in general wards (P=0.001) The ranking in the frequency of infection sites were 33.8% in respiratory tract, 29.3% blood stream, and 17.1% urinary tract. Men had slightly higher rate of infection than women and proportion at 1.9:1. Sixty-six percent of patients were over 65 years old, and it showed no significant differences in sex arid age between ICU and general-ward patients The significant predisposing factors of general-ward patients were ma1gnancies, chronic obstructive pulmonary disease, and long-term bedridden status; and those for ICU patients were insertion of central venous catheter, Foley catheter, endotracheal tube, use of medical ventilator (ventilator-associated pneumonia were 77%), and total parenteral nutrition. In this study, 0-8% of A. baumannii nosocomial infections were imipenem-resistant. The rates of MDRAB were 4.5% in 1995, 70.9% in 2001 and 50% in 2004 The rates of A. baumannii resistant to all antibiotics routinely tested at this medical center were 0-0.8% between 1995 to 2001, and gradually increased from 2.2% in 2002, to 5.3% in 2004. The data showed that the rate of nosocomial infection due to A. baumannii was higher in ICU than in general wards and the predisposing factors of patients in these two areas were different: mainly invasive manipulations in ICU, versus under ling diseases in general wards However, the infection site was mostly respiratory tract. MDRAB should he considered as an important pathogen for nosocomial respiratory tract infection in ICU, particularly ventilator-associated pneumonia (VAP).
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