전국의료관련감염감시체계 중환자실 부문 결과 보고: 2016년 7월부터 2017년 6월

Abstract

배경: 전국의료관련감염감시체계(Korean National Healthcare-associated Infections Surveillance System, KONIS) 중환자실 부문에서 2016년 7월부터 2017년 6월까지 감시를 수행한 열 번째 연간 자료 보고이다. 방법: 전국에 있는 193개 병원의 285개 중환자실에서 발생한 의료관련 요로감염, 혈류감염, 폐렴에 대해 전향적으로 감시를 수행하였다. 의료관련감염률과 기구관련 의료관련감염률은 1,000 재원일수(patient-days, PD) 또는 1,000 기구일수(device-days, DD) 당 감염 건수로 구하였다. 기구사용비는 기구일수/재원일수로 계산하였다. 결과: 총 3,989건의 의료관련감염이 발생하였는데, 요로감염이 1,241건, 혈류감염이 1,757건, 폐렴이 991건이었다. 유치도뇨관 관련 요로감염은 1,189건으로 1.01/1,000 DD (95% 신뢰구간, 0.95-1.07)이었고, 유치도뇨관 사용비는 0.85 (95% 신뢰구간, 0.849-0.851)로 각각 전년도의 0.88/1,000 DD (95% 신뢰구간, 0.82-0.95)와 0.84 (95% 신뢰구간, 0.839-0.841)에 비해 높았다. 중심정맥관 관련 혈류감염은 1,481건으로 감염률은 2.23/1,000 DD (95% 신뢰구간, 2.12-2.35)이었고, 중심정맥관 사용비는 0.48 (95% 신뢰구간, 0.479-0.481)였다. 인공호흡기 관련 폐렴은 480건으로 감염률은 1.00/1,000 DD (95% 신뢰구간, 0.91-1.09)이었고, 인공호흡기 사용비는 0.35 (95% 신뢰구간, 0.349- 0.351)이었다. 결론: 전년도 자료와 비교할 때 전체 의료관련감염률은 유사하였으나 유치도뇨관 관련 요로감염 발생률이 증가하였다.

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 2016 through June 2017. Methods: We performed a prospective surveillance of healthcare-associated urinary tract infection (UTI), bloodstream infection (BSI), and pneumonia (PNEU) at 285 ICUs in 193 hospitals using KONIS surveillance system. Healthcare-associated infection (HAI) and device-associated infection rates were calculated as the numbers of infections per 1,000 patient-days (PD) and device-days (DD), respectively. Device utilization was calculated as a ratio of device days to patient days. Results: A total of 3,989 HAIs were found during the study period; 1,241 UTIs (1,189 cases were urinary catheter-associated), 1,757 BSIs (1,481 were central line-associated), and 991 PNEUs (480 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTI) was 1.01 cases per 1,000 DD (95% confidence interval [CI], 0.95–1.07) and urinary catheter utilization ratio was 0.85 (95% CI, 0.849–0.851). These were higher than the data of the previous year, 0.88/1,000 DD (95% CI, 0.82-0.95) and 0.84 (95% CI 0.839-0.841), respectively. The rate of central line-associated BSIs was 2.23/1,000 DD (95% CI, 2.12–2.35) while the central line utilization ratio was 0.48 (95% CI, 0.479–0.481). The rate of ventilator-associated PNEUs was 1.00/1,000 DD (95% CI, 0.91–1.09) while the ventilator utilization ratio was 0.35 (95% CI, 0.349–0.351). Conclusion: The overall HAI rate was similar to that of the previous year but the rate of CAUTI increased.