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Eun Jin Kim1, Yee Gyung Kwak2, Tae Hyong Kim3, Mi Suk Lee4, Sang-Oh Lee5, Sung Ran Kim6, Sun Hee Park7, Jin Young Ahn8, Na Ra Yun9, Seong Yeol Ryu10, Eu Suk Kim11, Ji-youn Choi12, Hyeon Mi Yoo13, Myoung Jin Shin14, So-Yeon Yoo15, Ki Ho Hong16, Hee-Won Moon17, Nan-hyoung Cho18, Hee Jung Son19, Su Hyun Kim20, Young Hwa Choi1
, Mi-Na Kim21
, Mi-Na Kim21
Abstract
Background
In this report, we present annual data from the intensive care unit (ICU) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2017 through June 2018.
Methods
We performed prospective surveillance of healthcare-associated urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU) at 308 ICUs in 216 hospitals using the KONIS. Healthcare-associated infection (HAI) rates and device-associated infection rates were calculated as the number of infections per 1000 patient-days (PD) and device-days (DD), respectively. Device utilization was calculated as a ratio of DD to PD.
Results
A total of 4569 HAIs were found during the study period: 1530 UTIs (1476 cases were urinary catheter-associated), 2006 BSIs (1692 were central line-associated), and 1033 PNEU cases (505 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTI) was 1.16 cases per 1000 DD (95% confidence interval [CI]: 1.10–1.22) and urinary catheter utilization ratio was 0.86 (95% CI: 0.859–0.861). These results were higher than those in the previous year: 1.01 cases per 1000 DD (95% CI: 0.95–1.07) and 0.85 (95% CI: 0.849–0.851), respectively. The rate of central line-associated BSIs was 2.29 cases per 1000 DD (95% CI: 2.18–2.40) and the central line utilization ratio was 0.50 (95% CI: 0.499–0.501). The rate of ventilator-associated PNEU cases was 0.96 cases per 1000 DD (95% CI: 0.88–1.05) and the ventilator utilization ratio was 0.35 (95% CI: 0.349–0.351).
Figures and Tables
Table 1
Characteristics of hospitals and intensive care units participated in KONIS from July 2017 through June 2018
Table 2
Pooled means of healthcare-associated infection rates, by number of hospital beds, July 2017 through June 2018
*Pooled mean=(No. of UTIs, BSIs, or PNEUs / No. of patient-days)×1,000; †Pooled mean=(No. of UTIs / No. of patient-days)×1,000; ‡Pooled mean=(No. of BSIs / No. of patient-days)×1,000; §Pooled mean=(No. of PNEUs / No. of patient-days)×1,000.
Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.
Table 3
Pooled means and percentiles of the device-associated infection rates, by number of hospital beds, July 2017 through June 2018
*Pooled mean=(No. of urinary catheter-associated UTIs / No. of urinary catheter-days)×1,000; †Pooled mean=(No. of central line-associated BSIs / No. of central line-days)×1,000; ‡Pooled mean=(No. of ventilator-associated PNEUs / No. of ventilator-days)×1,000.
Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.
Table 4
Pooled means and percentiles of the distribution of device-utilization ratios, by number of hospital beds, July 2017 through June 2018
*Pooled mean=(No. of urinary catheter-days / No. of patient-days); †Pooled mean=(No. of central line-days / No. of patient-days); ‡Pooled mean=(No. of ventilator-days / No. of patient-days).
Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.
Table 5
Pooled means and percentiles of the distribution of device-associated infection rates, by type of ICU, July 2017 through June 2018
*Pooled mean=(No. of urinary catheter-associated UTIs / No. of urinary catheter-days)×1,000; †Pooled mean=(No. of central line-associated BSIs / No. of central line-days)×1,000; ‡Pooled mean=(No. of ventilator-associated PNEUs / No. of ventilator-days)×1,000.
Abbreviations: ICU, intensive care unit; MICU, medical ICU; MCICU, medical combined ICU; SCICU, surgical combined ICU; SICU, surgical ICU; NSICU, neurosurgical ICU; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.
Table 6
Pooled means and percentiles of the distribution of device-utilization ratios, by type of ICU, July 2017 through June 2018
*Pooled mean=(No. of urinary catheter-days / No. of patient-days); †Pooled mean=(No. of central line-days / No. of patient-days); ‡Pooled mean=(No. of ventilator-days / No. of patient-days).
Abbreviations: ICU, intensive care unit; MICU, medical ICU; MCICU, medical combined ICU; SCICU, surgical combined ICU; SICU, surgical ICU; NSICU, neurosurgical ICU; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval.
Table 7
Number (%) of microorganisms isolated from clinical specimens of patients with nosocomial infections
Acknowledgements
This study was supported by a grant of year 2018 (M2018A060000011) from the Korea Centers for Disease Control and Prevention.
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