2004년도 전국 16개 대학병원 중환자실 병원감염 감시 결과

Abstract

BACKGROUND: This study was to evaluate a nationwide nosocomial infection rate and antimicrobial resistance in intensive care units(ICUs) in Korea. METHODS: The study was carried out at 16 university-affiliated teaching hospitals from July through October 2004. We performed a prospective multicenter study to investigate nosocomial infection rates, device-associated infection rated, and causative pathogens and their antimicrobial resistance. RESULTS: The urinary tract was the most commonly involved site. Nosocomial infection rate was 12.48 in medical. ICU (MICU), 9.59 in medical surgical ICU (MSICU), 14.76 in surgical ICU (MSICU), and 11.60 in other lCU. Device-associated infection rates were as follow: 1) rates of urinary catheter-associated urinary tract infection were 4.26 in MICU, 3.17 in SICU, 4.88 in MSICU, and 5.87 in other ICU; 2) rates of central line-associated bloodstream infection were 3.24 in MICU, 1.56 in SlCU, 2.36 in MSICU, and 1.78 in other ICU; 3) rates of ventilator-associated pneumonia were 3.61 in MlCU, 13.05 in SICU, 1.68 in MSICU, and 4.84 in other lCU. Staphylococcus aureus was the most frequently identified microorganism in this study; 93% of S. aurues were resistant to methicillin; 17% of Pseudomonas aeruginosa isolated were resistant to imipenem; 11% of Enterococcus faecium and 18% of Enterococcus faecalis showed resistance to vancomycin. Over a half of Acinetobacter spp, Stenotrophomonas maltophilia, Klebsiella pneumoniae, and Escherichia coli showed resistant to fluoroquinolone. CONCLUSION: This study shows the seriousness of antimicrobial resistance and the importance of infection control in the lCU in Korea. This study should provide a theoretical strategy to enforce the infection control.