四个国家下呼吸道医院感染现患率调查（翻译有奖）

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Four country healthcare-associated infection prevalence survey: pneumonia and lower respiratory tract infections
Journal of Hospital Infection
Volume 74, Issue 3, March 2010, Pages 266-270
Summary
In 2006, the Hospital Infection Society was funded by the respective health services in England, Wales, Northern Ireland and the Republic of Ireland to conduct a prevalence survey of healthcare-associated infection (HCAI). Here, we report the prevalence of pneumonia and lower respiratory tract infection other than pneumonia (LRTIOP) in these four countries. The prevalence of all HCAIs was 7.59% (5743 out of 75 694). Nine hundred (15.7%) of these infections were pneumonia, and 402 (7.0%) were LRTIOP. The prevalence of both infections was higher for males than for females, and increased threefold from those aged <35 to those aged >85 years (P < 0.001). At the time of the survey or in the preceding seven days, 23.7% and 18.2% of patients with pneumonia and LRTIOP, respectively, were mechanically ventilated compared to 5.2% of patients in the whole study population. Meticillin-resistant Staphylococcus aureus (MRSA) was the cause of pneumonia and LRTIOP in 7.6% and 18.1% of patients, respectively (P < 0.001). More patients with LRTIOP (4.2%) had concurrent diarrhoea due to Clostridium difficile compared to patients with pneumonia (2.4%), but this did not reach statistical significance. Other HCAIs were present in 137 (15.2%) of patients with pneumonia and 66 (16.4%) of those with LRTIOP. The results suggest that reducing instrumentation, such as mechanical ventilation where possible, should help reduce infection. The higher prevalence of MRSA as a cause of LRTIOP suggests a lack of specificity in identifying the microbial cause and the association with C. difficile emphasises the need for better use of antibiotics.

Keywords: Clostridium difficile; Healthcare-associated infection; Lower respiratory tract infection; Meticillin-resistant Staphylococcus aureus; Pneumonia

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4个国家的卫生保健相关感染现患率调查：肺炎和下呼吸道感染
医院感染杂志 74卷3期，2010年3月，页266-270
摘要   2006年，医院感染会的费用由英格兰，威尔士，北爱尔兰和爱尔兰共和国各自的医疗服务，进行医疗卫生现状调查相关感染（HCAI）。在这里，我们报告的肺炎患病率和下呼吸道感染这四个国家不是肺炎（LRTIOP）其他。所有HCAIs患病率为7.59％（5743出75 694）。九100（15.7％，这些感染）的肺炎，和402（7.0％）为LRTIOP。这两个感染患病率较高，男性高于女性，以及来自岁的人的三倍“35岁”85岁性（P“0.001）。在调查或前7天，23.7％和18.2肺炎和LRTIOP，时间分别为％的患者，是机械通气相比，5.2％的患者在整个研究人群。耐甲氧西林金黄色葡萄球菌（MRSA）是在7.6％，导致肺炎和LRTIOP和18.1％的患者组（P“0.001）。与LRTIOP（4.2％）更多腹泻病人同时由于难辨梭状芽胞杆菌肺炎相比（2.4％）患者，但没有达到统计学意义。其他HCAIs人出席在137（15.2％的肺炎和66（16.4％与LRTIOP者）患者）。结果表明，仪器仪表，如减少机械通气在可能的情况，应有助于减少感染。较高的葡萄球菌作为一个LRTIOP导致患病率表明了特异性识别微生物的事业和艰难与C缺乏强调了协会为更好地使用抗生素的需要。

关键词：艰难梭菌，保健相关感染，下呼吸道感染;耐甲氧西林金黄色葡萄球菌，肺炎

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摘要   2006年，医院感染协会在英格兰，威尔士，北爱尔兰和爱尔兰共和国等国家医疗机构的资助下，进行了医院感染发病率的调查。在这里，我们报告这四个国家肺炎和（非肺炎性）下呼吸道感染（LRTIOP）的发生率情况。医院感染（HCAIs）总发生率为7.59％（5743／75694），其中900（15.7％）是肺炎，402（7.0％）为LRTIOP。两个感染率中男性高于女性，小于35岁或大于85岁的患者中该感染的发生率增加三倍（P＜0.001）。在调查当时或前7天，使用了机械通气而感染肺炎和LRTIOP的患者中分别为23.7％和18.2，而所有感染患者中只有5.2％使用机械通气。耐甲氧西林金黄色葡萄球菌（MRSA）肺炎和LRTIOP分别为7.6％和18.1％（P＜0.001）。虽然感染LRTIOP并同时存在难辨梭状芽胞杆菌腹泻（4.2％）比感染肺炎（并同时存在难辨梭状芽胞杆菌引起的腹泻）（2.4％）的患者多，但无统计学意义。其他（医院感染）病例中发生肺炎和LRTIOP分别为137（15.2％）和66（16.4％）。结果表明，如尽可能减少侵入性操作，如机械通气等，应有助于减少医院感染。本研究显示，较高的MRSA感染率并成为LRTIOP感染的一个因素，可能是由于缺乏特异性识别病原微生物的方法，也导致或关联于难辨梭状芽胞杆菌的感染，强调更有效地使用抗生素。