Trends in device utilization ratios in intensive care units over 10-year period in South Korea: device utilization ratio as a new aspect of surveillance

Kim, E J; Kwak, Yee Gyung; Park, S H; Kim, S R; Shin, Myoung Jin; Yoo, Hyeon Mi; Han, Su Ha; Kim, D W; Choi, Young Hwa; Yoo, Jin‐Hong

doi:10.1016/j.jhin.2017.10.007

Cited by 12 publications

(8 citation statements)

References 23 publications

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“…We believe that essential elements that contributed to the sustained decrease in the incidence of HAI in Taiwan, Korea and Japan were the national surveillance programs combined with improvement in IPC practices [ 16 ]. In Korea, there was a significant decline in device-associated HAI in association with the implementation of the KONIS program [ 17 ]. National IPC programs such as hand hygiene, care bundles, antimicrobial stewardships, and environmental hygiene have been shown to effectively reduce HAI and infections caused by AMR pathogens [ 7 , 18 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: recent trends based on national surveillance reports

Chiang

Pan

Yang

et al. 2018

Antimicrob Resist Infect Control

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BackgroundSustainable systematic interventions are important for infection prevention and control (IPC). Data from surveillance of healthcare-associated infections (HAI) provides feedback for implementation of IPC programs. To address the paucity of such data in Asia, we searched for national HAI surveillance and IPC programs in this region.MethodsData were analysed from open access national surveillance reports of three Asian countries: Taiwan, South Korea and Japan from 2008 to 2015. National IPC programs were identified.ResultsThere were differences among the countries in surveillance protocols, hospital coverage rates, and national IPC policies and programs. Nevertheless, there was a 53.0% reduction in overall HAI over the 8-year period. This consisted of a decrease from 9.34 to 5.03 infections per 1000 patient-days in Taiwan, from 7.56 to 2.76 in Korea, and from 4.41 to 2.74 in Japan (Poisson regression, all p < 0.05). Across the three countries, Escherichia coli and Candida albicans were the major pathogens for urinary tract infection. Staphylococcus aureus, Acinetobacter baumannii and Enterococcus faecium were common bloodstream pathogens. For pneumonia, S. aureus, A. baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae were the predominant pathogens, with considerable country differences. There was a 64.6% decrease in the number of isolates of methicillin-resistant S. aureus, 38.4% decrease in carbapenem-resistant P. aeruginosa and 49.2% decrease in carbapenem-resistant A. baumannii (CRAB) in Taiwan (all p < 0.05), and similarly in Korea with the exception of CRAB (30.5 and 50.4% reduction, respectively, both p < 0.05).ConclusionWe found a significant decrease in HAI across the three countries in association with sequential multifaceted interventions such as hand hygiene, care bundles, and antimicrobial stewardships. Further regional collaboration could be forged to develop joint strategies to prevent HAI.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0422-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: recent trends based on national surveillance reports

Chiang

Pan

Yang

et al. 2018

Antimicrob Resist Infect Control

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“…The high proportion of candidemia found in this study may be attributable to the use of more invasive devices. In a previous KONIS study, the DUR was reported to remain similar over 10years without a significant decrease in the DUR for C-lines (14).…”

Section: Discussionmentioning

confidence: 82%

“…In another study in the Republic of Korea, the average incidence of candidemia at nine university hospitals in 2011 was 2.01 cases/10,000 PDs (18). The participating hospitals' overall HAI incidence rate was found to have decreased significantly during the study period (14). The CLABSI incidence rate showed a particularly marked decrease since continuous KONIS surveillance (19).…”

Section: Discussionmentioning

confidence: 95%

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Trends in the Epidemiology of Candidemia in Intensive Care Units From 2006 to 2017: Results From the Korean National Healthcare-Associated Infections Surveillance System

et al. 2020

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Candidemia is an important healthcare-associated infection (HAI) in intensive care units (ICUs). However, limited research has been conducted on candidemia in the Republic of Korea. We aimed to analyze the secular trends in the incidence and distribution of candidemia in ICUs over 12-years using data from the Korean National Healthcare-Associated Infections Surveillance System (KONIS). KONIS was established in 2006 and has performed prospective surveillance of HAIs including bloodstream infections (BSIs) in ICUs. We evaluated the trends in the distribution of causative pathogens and the incidence of candidemia. From 2006 to 2017, 2,248 candidemia cases occurred in 9,184,264 patient-days (PDs). The pooled mean incidence rates of candidemia significantly decreased from 3.05 cases/10,000 PDs in 2006 to 2.5 cases/10,000 PDs in 2017 (P = 0.001). Nevertheless, the proportion of candidemia gradually increased from 15.2% in 2006 to 16.6% in 2017 (P = 0.001). The most frequent causative pathogen of BSIs from 2006 to 2012 was Staphylococcus aureus; however, Candida spp. emerged as the most frequent causative pathogen since 2013. C. albicans (39.9%) was the most common among Candida spp. causing BSIs, followed by Candida tropicalis (20.2%) and Candida parapsilosis (18.2%). The proportion of candidemia caused by C. glabrata significantly increased from 8.9% in 2006 to 17.9% in 2017 (P < 0.001). There was no significant change in the distribution of Candida spp. by year (P = 0.285). The most common source of BSIs was central lines associated BSI (92.5%). There was a significant increase in the proportion of candidemia by year in hospitals with organ transplant wards (from 18.9% in 2006 to 21.1% in 2017, P = 0.003), hospitals with <500 beds (from 2.7% in 2006 to 13.6% in 2017, P < 0.001), and surgical ICUs (from 16.2% in 2006 to 21.7% in 2017, P = 0.003). The proportion of candidemia has increased in Korea, especially in hospitals with <500 beds and surgical ICUs. Thus, appropriate infection control programs are needed.

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“…Accurate nationwide surveillance of antimicrobial-resistant bacteria is becoming more important to establish the optimal treatment guidelines for empirical therapy. The Korean Nosocomial Infections Surveillance System [ 9 ], Korean Nationwide Surveillance of Antimicrobial Resistance [ 10 ], Korean Network for Study on Infectious Disease, and Korean Antimicrobial Resistance Monitoring System (KARMS) have all played roles in Korea [ 7 ]. KARMS was launched by the Korean Center for Disease Control and Prevention (KCDC) in 2002 and reported on the prevalence and characteristics of MDROs from 31 secondary or tertiary hospitals within a finite period.…”

Section: Recent Antimicrobial Resistance Rates Of Gram-negative Bacilmentioning

confidence: 99%

Epidemiology and treatment of antimicrobialresistant gram-negative bacteria in Korea

Kim

Park

2018

Korean J Intern Med

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Antimicrobial resistance is becoming one of the greatest challenges to public health worldwide. Infections by antimicrobial-resistant organisms could result in the failure of treatment, increased medical costs, prolonged hospital stays, and an increased socioeconomic burden. Antimicrobial usage in Korea remains heavy, even after much effort to reduce their use. According to the Korean antimicrobial resistance surveillance system, the resistance rates of many bacteria are increasing. The resistance rate of Acinetobacter baumannii to imipenem in Korea increased to 85% in 2015, representing a major public threat. The reports of increased carbapenem resistance in Enterobacteriaceae are worrisome. More importantly, some carbapenem-resistant Enterobacteriaceae may result from the production of carbapenemases, which break down carbapenems. There are relatively few treatment options for extensively drug-resistant A. baumannii and carbapenem-resistant Enterobacteriaceae. Most reports are retrospective observational studies. Because there are little published data from randomized controlled trials, more data assessing antimicrobial treatment for extensively drug-resistant A. baumannii and carbapenem-resistant Enterobacteriaceae are needed to make treatment recommendations.

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Trends in device utilization ratios in intensive care units over 10-year period in South Korea: device utilization ratio as a new aspect of surveillance

Cited by 12 publications

References 23 publications

Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: recent trends based on national surveillance reports

Healthcare-associated infections in intensive care units in Taiwan, South Korea, and Japan: recent trends based on national surveillance reports

Trends in the Epidemiology of Candidemia in Intensive Care Units From 2006 to 2017: Results From the Korean National Healthcare-Associated Infections Surveillance System

Epidemiology and treatment of antimicrobialresistant gram-negative bacteria in Korea

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