2020-2022年苏州市区域性医院感染监测平台导尿管相关尿路感染监测数据分析

Monitoring data of urinary catheter-associated urinary tract infections from Suzhou regional nosocomial infection monitoring platforms in 2020-2022

目的 分析苏州市51所医院导尿管相关尿路感染(CAUTI)特点,为感染防控提供依据。方法 通过苏州市区域性医院感染监测平台对2020年1月-2022年12月上报的CAUTI监测数据进行统计分析。结果 2020-2022年共发生CAUTI患者2734例次(0.99‰),三级医院(1.03‰)高于二级医院(0.74‰),其中三级综合医院和二级专科医院较高(P<0.05)。2544株病原菌中革兰阴性菌占比最高(56.29%),革兰阳性菌和真菌分别为22.80%和20.91%。二级和三级医院病原菌分布有一定差异,但均以大肠埃希菌、肺炎克雷伯菌、白假丝酵母、屎肠球菌和铜绿假单胞菌为主。碳青霉烯类耐药肺炎克雷伯菌(CRKP)构成比最高(63.38%),其检出率为60.94%。肺炎克雷伯菌和鲍氏不动杆菌仅对替加环素和米诺环素较为敏感。大肠埃希菌对除喹诺酮类的多数抗菌药物保持高度敏感,碳青霉烯类耐药大肠埃希菌(CREC)则呈高度耐药。铜绿假单胞菌对多数抗菌药物的耐药率低于25.00%,碳青霉烯类耐药铜绿假单胞菌(CRPA)仅对氨基糖苷类药物较敏感。粪肠球菌和屎肠球菌对万古霉素、替考拉宁、利奈唑胺、替加环素的耐药率均低于5.00%。白假丝酵母、热带假丝酵母和光滑假丝酵母对常用抗菌药物的耐药率均低于35.00%。结论 本市不同医院CAUTI流行特点和不同菌株耐药性存在差异,应加强监测指导感染防控。

OBJECTIVE To analyze the characteristics of urinary catheter-associated urinary tract infections(CAU-TI)in 51 hospitals of Suzhou so as to provide guidance for prevention and control of the infections.METHODS The monitoring data of CAUTI that were reported from Jan 2020 to Dec 2022 were statistically analyzed by Suzhou re-gional nosocomial infection monitoring platforms.RESULTS A total of 2734(0.99‰)case-times of patients had CAUTI from 2020 to 2022,the incidence was significantly higher in the tertiary hospitals(1.03‰)than in the secondary hospitals(0.74‰),the incidence of CAUTI was relatively high in the tertiary general hospitals and the secondary specialized hospitals(P<0.05).Among 2544 strains of pathogens,56.29%were gram-negative bacte-ria,22.80%were gram-positive bacteria,and 20.91%were fungi.There was certain difference in the distribution of pathogens between the secondary hospitals and the tertiary hospitals;Escherichia coli,Klebsiella pneumoni-ae,Candida albicans,Enterococcus faecium and Pseudomonas aeruginosa were dominant among the pathogens.The constituent ratio of the carbapenem-resistant K.pneumoniae(CRKP)was the highest(63.38%),and the iso-lation rate was 60.94%.K.pneumoniae and Acinetobacter baumannii strains were relatively sensitive to tigecycline and minocycline.The E.coli strains maintained highly sensitive to most of the antibiotics except for quinolones,and carbapenem-resistant E.coli(CREC)strains showed high drug resistance.The drug resistance rate of the P.aeruginosa strains to most of the antibiotics was less than 25.00%,and carbapenem-resistant P.aeruginosa(CR-PA)was sensitive to aminoglycosides.The drug resistance rates of the Enterococcus faecalis and E.faecium strains to vancomycin,teicoplanin,linezolid and tigecycline were less than 5.00%.The drug resistance rates of the C.albicans,Candida tropicalis and Candida glabrata to the commonly used antibiotics were less than 35.00%.CONCLUSION There are significant differences in the epidemiological characteristics of CAUTI and drug resistance of the strains among the hospitals in the city.It is necessary to strengthen the monitoring and take targeted pre-vention and control measures.