バイタルサイン:中心静脈関連血流感染－アメリカ、2001、2008、2009年

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ホーム IMICライブラリ MMWR抄訳 2011年（Vol.60)バイタルサイン:中心静脈関連血流感染－アメリカ、2･･･

MMWR抄訳

2011/03/04Vol. 60 / No. 8

MMWR60(8)243-248
Vital Signs: Central Line-Associated Blood Stream Infections － United States, 2001, 2008, and 2009

バイタルサイン:中心静脈関連血流感染－アメリカ、2001、2008、2009年

アメリカでは毎年、入院患者の約5%が医療関連感染(Health-care-associated infections:HAIs)を発症しており、HAIsのなかでも中心静脈関連血流感染(CLABSIs)は死亡率が15～25%と報告されている。今回、CDCは2008、2009年のICU、入院病棟、外来透析施設におけるCLABSIs症例数の調査を行い、2001年のデータと比較した。 2001年、ICU入院患者におけるCLABSIs症例(1歳以上)は約43,000例、2009年は約18,000例であり、この症例数の減少は黄色ブドウ球菌によるCLABSIsの減少が大きな要因となっており(73%減、RR=0.27、95%CI=0.238-0294)、他にグラム陰性菌(クレブシェラ菌、大腸菌、アシネトバクター・バウマニ、緑膿菌:37%減、RR=0.63、CI=0.568-0.692)、カンジダ菌(46%減、 RR=0.54、CI=0.487-0.606)、腸球菌(55%減、RR=0.45、CI=0.408-0.491)などによる感染も大きく減少していた。また、2009年の入院病棟におけるCLABSIs症例は約23,000例、2008年の外来透析施設におけるCLABSIs症例は約37,000例と推定されている。ICUにおけるCLABSIs症例が2009年に約25,000例(58%)減少したことから、約6,000例の命が救われ、医療費は約41,400万ドル削減し、2001年以降の累積削減額は18億ドルに達する。今後は入院病棟および外来透析施設での症例数の減少が課題である。

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