Korean National Healthcare-associated Infections Surveillance System, Intensive Care Unit Module Report: Summary of Data from July 2015 through June 2016

Abstract

BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2015 through June 2016. METHODS: We performed a prospective surveillance of healthcare-associated urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia (PNEU) at 178 ICUs in 103 hospitals using KONIS surveillance system. Healthcare-associated infections (HAI) rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 2,608 HAIs were found during the study period: 718 UTIs (702 cases were urinary catheter-associated), 1,236 BSIs (1,058 were central line-associated), and 654 PNEUs (389 were ventilator-associated). The rate of catheter-associated UTIs (CAUTI) was 0.88 cases per 1,000 device-days (95% confidence interval [CI, 0.82-0.95]) and urinary catheter utilization ratio was 0.84 (95% CI, 0.839-0.841). The rate of central line-associated BSIs (CLABSI) was 2.20 (95% CI, 2.07-2.33) per 1,000 device-days and the utilization ratio was 0.51 (95% CI, 0.509-0.511). The rate of ventilator-associated PNEUs (VAPs) was 1.00 (95% CI, 0.91-1.11) per 1,000 device-days and the utilization ratio was 0.41 (95% CI, 0.409-0.411). The ventilator utilization ratio was lower: however, VAPs were more common in the ICUs of hospitals with 700-899 beds (1.23 [95% CI, 1.07-1.42]) than in those of hospitals with more than 900 beds (0.87 [95% CI, 0.71-1.06]). CONCLUSION: Compared with the previous year, the device utilization ratio was similar but the rate of VAP was significantly decreased.

배경: 전국의료관련감염감시체계(Korean National Healthcare-associated Infections Surveillance System, KONIS) 중환자실 부문에서 2015년 7월부터 2016년 6월까지 감시를 수행한 아홉 번째 연간 자료를 정리하여 보고한다. 방법: 전국에 있는 103개 병원의 178개 중환자실에서 발생한 의료기관관련 요로감염, 혈류감염, 폐렴에 대해 전향적으로 감시를 수행하였다. 의료관련감염률은 1,000 재원일수 또는 기구일수 당 감염 건수로 구하였다. 결과: 총 2,608건의 의료관련감염이 발생하였는데, 요로감염이 718건, 혈류감염이 1,236건, 폐렴이 654건이었다. 요로카테터 관련 요로감염은 702건으로 1,000 기구일수 당 0.88건(95% 신뢰구간, 0.82-0.95)이었고, 요로카테터 사용률은 0.84(95% 신뢰구간, 0.839-0.841)였다. 중심정맥관 관련 혈류감염은 1,058건으로 감염률은 1,000 기구일수 당 2.20건(95% 신뢰구간, 2.07-2.33)이었고, 중심정맥관 사용률은 0.51 (95% 신뢰구간, 0.509-0.511)였다. 인공호흡기 관련 폐렴은 389건으로 감염률은 1,000 기구일수 당 1.00건(95% 신뢰구간, 0.91-1.11)이었고, 인공호흡기 사용률은 0.41(95% 신뢰구간, 0.409-0.411)이었다. 700-899병상의 중환자실에서 900병상 이상 규모의 병원 중환자실에 비해 기구사용률이 낮았음에도 인공호흡기 관련 폐렴이 더 흔하게 발생하였다(1,000 기구일수 당 1.23건 vs. 0.87건). 결론: 전년도와 비교할 때 기구사용률은 유사하였으나 인공호흡기 관련 폐렴 감염률은 유의하게 감소하였다.