2019-2023年加拿大急症医院医疗保健相关感染和抗菌素耐药性

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引用次数: 0

摘要

背景:医疗保健相关感染(HAIs)和抗菌素耐药性(AMR)继续导致加拿大人发病率和死亡率过高。目的:本报告利用医院向加拿大医院感染监测计划(CNISP)提交的监测和实验室数据以及省和地区实验室向国家微生物实验室提交的监测和实验室数据,描述了2019-2023年HAIs和AMR的流行病学和实验室特征和趋势。方法:2019年1月1日至2023年12月31日期间,从109家加拿大哨点急症医院收集了艰难梭菌感染(CDI)、耐甲氧西林金黄色葡萄球菌(MRSA)血液感染(bsi)、耐万古霉素肠球菌(VRE) bsi(特别是粪肠球菌和屎肠球菌)、产碳青霉烯酶肠杆菌(CPE)和产碳青霉烯酶鲍曼不动杆菌(CPA)的感染和定植以及耳念珠菌(C. auris)。趋势分析的病例数,发病率(率),结果,分子表征和抗菌素耐药性档案提出。结果:CDI的感染率保持相对稳定(范围:4.90-5.35感染/ 10,000患者日)和MRSA BSI(范围:1.00-1.16感染/ 10,000患者日),VRE BSI的感染率显著增加(范围:0.30-0.37感染/ 10,000患者日)。与其他HAIs相比,CPE的感染率仍然较低,但无显著性翻倍(率:0.08-0.16),CPA计数仍然很低(n=4例),耳球菌分离株仍然很低(n=36株)。结论:参加CNISP的加拿大急症医院MRSA BSIs和CDI的发病率保持稳定,VRE BSIs和CPE感染增加。分离到的金黄色葡萄球菌很少。报告标准化监测数据,为在急症护理医院应用感染预防和控制做法提供信息,对于帮助减轻加拿大艾滋病和抗生素耐药性的负担至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Healthcare-associated infections and antimicrobial resistance in Canadian acute care hospitals, 2019-2023.

Background: Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) continue to contribute to excess morbidity and mortality among Canadians.

Objective: This report describes epidemiologic and laboratory characteristics and trends of HAIs and AMR, 2019-2023, using surveillance and laboratory data submitted by hospitals to the Canadian Nosocomial Infection Surveillance Program (CNISP) and by provincial and territorial laboratories to the National Microbiology Laboratory.

Methods: Data was collected from 109 Canadian sentinel acute care hospitals between January 1, 2019 and December 31, 2023, for Clostridioides difficile infections (CDI), methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs), vancomycin-resistant Enterococcus (VRE) BSIs (specifically Enterococcus faecalis and Enterococcus faecium), carbapenemase-producing Enterobacterales (CPE) and carbapenemase-producing Acinetobacter baumannii (CPA) infections and colonizations and Candida auris (C. auris). Trend analysis for case counts, incidence rates (rates), outcomes, molecular characterization and AMR profiles are presented.

Results: Rates remained relatively stable for CDI (range: 4.90-5.35 infections per 10,000 patient days) and MRSA BSI (range: 1.00-1.16 infections per 10,000 patient days) and increased significantly for VRE BSIs (range: 0.30-0.37 infections per 10,000 patient days). Infection rates for CPE remained low compared to other HAIs but doubled non-significantly (rates: 0.08-0.16), CPA counts remained very low (n=4 cases) and C. auris isolates remained low (n=36 isolates).

Conclusion: The incidence of MRSA BSIs and CDI remained stable and VRE BSIs and CPE infections increased in the Canadian acute care hospitals participating in CNISP. Few C. auris isolates were identified. Reporting standardized surveillance data to inform the application of infection prevention and control practices in acute care hospitals is critical to help decrease the burden of HAIs and AMR in Canada.

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