seasonal variation in hospital pathogens - icpic 2011

8/2/2019 Seasonal Variation in Hospital Pathogens - ICPIC 2011

1/59

Xjcsgoci con wjctmjr-ljnkctjn

vcrkctkgo ko mgspktci pctmgdjos6

gppgrtuoktkjs bgr prjvjotkgo

Jik O. Qjrjohjvkhm, LN LX

Qrgbjssgr gb LjnkhkojZokvjrskty gb Kgwc, Hcrvjr Hgiijdj gb Ljnkhkoj

Kgwc Hkty, Kgwc

Brkncy, 3 Fuiy 5133 3463:


2/59

Gvjrvkjw

LNU-Chkojtgechtjr

Xglj jcriy jpknjlkgigdkhci wgr` crguon

Chkojtgechtjr

Xjcsgocikty

Ech`drguon stunkjs

Bkrst ZLLH stuny

385-mgspktci stuny


3/59

Chkojtgechtjr

Drcl-ojdctkvj hghhgechkiius

Tcs gbtjo vkjwjn cs c hgigokzjr

MCX CUUKRJN cs c ogsghglkci pctmgdjo

Chkojtgechtjr eculcookkks tmj lgst hgllgo Guterjc` gb klkpjojl-rjskstcot Chkojtgechtjr ko

Ojw [gr`

Nkbbkhuit tg jrcnkhctj hgigokzjn stctj

Jljrdjohj ko rjturokod trggps brgl tmj LknnijJcst


4/59

Ujbjrjohj Hikokhci Xjttkod Hcsjs Cttrkeutceij

Lgrtcikty

Chkojtgechtjr Kobjhtkgos Hglpcrjn tg Lcthmjn Zo-kobjhtjn Hgotrgis

Druppjr (5114) Ogsghglkci EXK

KHZ, Ksrcji

:5 EXK 82.:%

Eigt (5118) Ogsghglkci EXK

KHZ, Ejidkul

>: EXK 4.=%

ChkojtgechtjrKobjhtkgos Hglpcrjn tg Lcthmjn Hgotrgis wktm@ijeskjiicKobjhtkgo

Ugejosmtg` (5112) Ogsghglkci EXK

Ksrcji

335 EXK 55.4%

Luitknrud-UjskstcotChkojtgechtjrKobjhtkgos Hglpcrjn tg Lcthmjn Xushjptkeij Hgotrgis

@wgo (5114) HU-EXK

8* Hcrj, @grjc

>1 HU- Kobjhtkgos 5:-81%

Xuojosmkoj (5114) LNU-Kobjhtkgos

8* Hcrj0 Ecitklgrj

;2 LNU-Kobjhtkgos =.>%

Ijj (5114) LUN-Kobjhtkgos

8* Hcrj, ckwco

>= LNU-EXK 53.=%

Luitknrud-UjskstcotChkojtgechtjr Kobjhtkgos Hglpcrjn tg Lcthmjn Zo-kobjhtjn Hgotrgis

Xuojosmkoj (5114) LNU-Kobjhtkgos

8* Hcrj, Ecitklgrj

;2 LNU-Kobjhtkgos 3>.=%

Qicybgrn (5114) HU-Kobjhtkgo/HgigokzctkgoKHZ, Custrcikc

22 HU-Kobjhtkgos grHgigokzctkgo

51%


5/59

Echtjrkc HICEXK

(%

klkpjojl

rjskstcot)

RCQ

(%

klkpjojl

rjskstcot)

HCZ^K

(%

klkpjojl

rjskstcot)

Qggijn

(%

klkpjojl

rjskstcot)

Qsjunglgocs 58.1% 5:.3% 52.>% 5:.8%

@ijeskjiic 31.=% 31.3 8.2

Chkojtgechtjr 5;.5 5:.2 82.=

OMXO6 klpjojl-rjskstcohj


6/59

Tmy ng K hcrj cegut CE7

Fuiy 5115, LKHZ

Jvjrygoj go vchctkgo, jxhjpt

: pctkjots wktm LNU-CE echtjrjlkc ko Fuiy > ko Cudust

Hgotrgi pico

Xmut LKHZ Qrjss

Eco crtkbkhkci ockis

1

3

5

8

>

:


7/59

Tmct mcppjojn7

Zokvjrsci dgwo/digvj kostktutjn ko LKHZ

con XKHZ

Chtkvj survjkiicohj go cii trcosbjrs brgl

gutsknj mgspktcis0 ksgictjn uotki huiturjs

rjturo

Xtctjwknj CE survjkiicohj (5131)


8/59

^mj Xgurhj!

3=1-ejn, ZLLH-cbkiikctjn I^CH3

3>4 pctkjot pgkot prjvcijohj survjy (35/1:)

5=% CE+ (>3 pctkjots) Xjosktkvkty ey sktj 55% pjrk-rjhtci,

2=% sputul, 55% wguon

5131 Xurvjy gb :4 Lcryicon Bchkiktkjs5

3. Buruog F jt ci, Cl F Kobjht Hgotrgi 511=

5. ^mgl @ (uopueiksmjn)


9/59

^rcoslksskekikty con Qrgtjhtkgo

Grdcoksl

MHT

Uggl

Jotrkjs

Mcon +

Ejbgrj

(%)

Dgwo

con/gr

Digvj +

Cbtjr %

Mcons +

Cbtjr

Ujlgvci

Jbbjhtkvjojss

gb QQJ

C. eculcook k3 515 3.:% 8=.4% >.:% ==%

Q. cjrudkogsc3 388 1% =.5% 1.4% ;1%

RUJ5 ;> 1% ;% 1% 311%

LUXC5 =3 5% 3;% 5.2% =:%

3. Lgrdco N, jt ci, Kobjht Hgotrgi Mgsp Jpknjlkgi Fuiy 51310 83(4)6432-53.5. Xoynjr D, jt ci, Kobjht Hgotrgi Mgsp Jpknjlkgi Fuiy 511=0 5;(4)6:=>-:=;

BGU LGUJ KOBG...


10/59

Cnn ko ighci mcon mydkjoj

cnmjrjohj rctjs1 82% 51% 34% 3>% 33% =% :%

:1% 3=% 31% ;% 4% :% >% 5%

21% 3:% =% 4% 2% >% 8% 5%

41% 33% 2% :% >% 8% 5% 3%

=1% 4% >% 8% 8% 5% 5% 3%

;1% >% 5.% 5% 3% 3% 3% 3%311% 1 1 1 1 1 1 1

1 :1% 21% 41% =1% ;1% 311%

Hglpikcohj wktm Digvjs (pctkjots go hgotcht prjhcutkgos)

HglpikcohjwktmMcon-Mydkjoj


11/59

Jovkrgoljotci Xclpikod

Qjrhjot gb rggls wktm pgsktkvj

jovkrgoljotci huiturjs bgr grdcoksl

`ogwo tg ej hgigokzkod pctkjot (QBDJ)

4=% Chkojtgechtjr

8:% RUJ

5=% LUXC

55% Q. cjrudkogsc

3:% @QH

3. Lgrdco N, jt ci, Xghkjty bgr Mjcitmhcrj Jpknjlkgigdy gb Cljrkhc (XMJC) 5131

BGU LGUJ KOBG...


12/59

Tmct jisj7

Guterjc` ko sulljr

Rjts rjturokod brgl Krcq mcn mkdm

kohknjohj gb kobjhtkgo wktm Chkojtgechtjr

^rgpkhci hiklctjs wktm lgrj CE kobjhtkgos

Hguin wjctmjr gr sjcsgo picy c rgij7 Kb bguon, hguin tmks citjr gur kobjhtkgo

prjvjotkgo prchtkhjs7


13/59

Xjcsgoci vcrkctkgo

Hjrtcko kobjhtkgos mcvj sjcsgoci vcrkctkgo

Kobiujozc, UXR, Ijdkgojiic*

Xjcsgoci vcrkctkgo ko mgspktci pctmgdjos7

Qrjvkgus stunkjs iklktjn dkvjo hglekojn nctc

Xjcttij sulljr cnnjn tg Mgustgo sulljr

Nkn ogt igg` ct tjlpjrcturj spjhkbkhciiy

BGU LGUJ KOBG...

Bkslco NO, F Kobjht Nks 511: Njh 3:03;5(35)65122-48


14/59

Xjcsgoci Rcrkctkgo CE

HNH OOKX 3;4>-3;44 mgspktci-wknj nctc3

5x kohrjcsj ko ictj sulljr vs jcriy wkotjr

HNH OOKX 3;=4-3;;2, 8>>4 KHZ ksgictjs5

:>% mkdmjr nurkod FuiyGhtgejr tmco nurkod

OgvjlejrFuoj (=.1 vs. :.5 pjr 31,111

pctkjotncys, p91.13)

Nkn ogt hgotrgi bgr ighctkgo, yjcr, tjlp jth.

Og vcrkctkgo ko Qsjunglgocs spp

3. Ujtckiikcu MB, jt ci. F Kobjht Nks 3;4;038;6843:5.5. LhNgocin IH jt ci. Hiko Kobjht Nks 3;;;03388-4.

BGU LGUJ KOBG...


15/59

Lgotmiy kohknjohj njoskty gb chkojtgechtjr kobjhtkgos6 kotjoskvj hcrj uokt

survjkiicohj hglpgojot, Octkgoci Ogsghglkci Kobjhtkgo Xurvjkiicohj

Xystjl, 3;=43;;2 (wmktj ecrs,C. eculcookk0 eich` ecrs, cii gtmjr

Chkojtgechtjrspjhkjs)

LhNgocin IH jt ci. Hiko Kobjht Nks 3;;;03388-4.

BGU LGUJ KOBG...


16/59

Lgotmiy kohknjohj njoskty gb Qsjunglgocs cjrudkogsckobjhtkgos6 kotjoskvj

hcrj uokt survjkiicohj hglpgojot, Octkgoci Ogsghglkci Kobjhtkgo

Xurvjkiicohj Xystjl, 3;=43;;2.

LhNgocin IH jt ci. Hiko Kobjht Nks 3;;;03388-4.

BGU LGUJ KOBG...


17/59

Xjcsgoci Rcrkctkgo gb Xjcsgo

511=

BGU LGUJ KOBG...

mttp6//www.ohnh.ogcc.dgv/sgth/konjx.pmp7rjpgrt


18/59

Xtuny

Ckl6 Cssjss bgr sjcsgoci vcrkctkgo ko

Qsjunglgocs cjrudkogsc, Chkojtgechtjr

eculcookk, Jotjrgechtjr higchcj, Jshmjrkhmkchgik, Xtcpmyighghhus curjus, con jotjrghghhk

=-yjcrs gb hikokhci huiturj nctc, ZLLH

Xulljr6 Fuiy-Xjptjlejr

Hglluokty-cssghkctjn 9>= mgurs, MC?>= mgurs

^klj-sjrkjs cociysks0 Qgkssgo DIL

BGU LGUJ KOBG...

Qjrjohjvkhm jt ci. Kobjht Hgotrgi Mgsp Jpknjlkgi Njh 511=6335>-83


19/59

Cnnktkgoci Ljtmgns

Cnfustjn bgr igod-tjrl trjons

Cssjssjn bgr tjlpjrcturj, mulknkty con

rckobcii jbbjhts

Cnfustjn bgr ogo-wjctmjr sjcsgocikty

?>= mgur con 9>= mgur bgr hglluokty vs.

mgspktci strckos r/g kotjro jbbjhts


20/59

Huiturjs con Xgurhjs

53=,:;> cnlksskgos

52,25> uokquj huiturjs (goj pjr pt / yjcr)

8,848Qsjunglgocs cjrudkogsc (8>% urkoj)

3,>>>Chkojtgechtjr eculcookk (8:% sputul)

3,=58Jotjrgechtjr higchcj (54% urkoj)

2,18:Jshmjrkhmkc hgik (4>% urkoj)

4,325Xtcpmyighghhus curjus (8;% wguon)

2,4=4 jotjrghghhk (:3% urkoj)


21/59

Hglluokty-cssghkctjn

Xpjhkjs% Hglluokty-cssghkctjn

(9>= mgurs)

Qsjunglgocs cjrudkogsc 84%

Chkojtgechtjr eculcookk 88%

Jotjrgechtjr higchcj 88%

Jshmjrkhmkc hgik :2%

Xtcpmyighghhus curjus 25%

jotjrghghhk 8;%


22/59

Xjcsgoci Rcrkctkgo ko DOU


23/59

Xjcsgoci DQH


24/59

Xulljr Qjc`s


25/59


26/59

Cnnktkgoci Xtunkjs


27/59

J. hgik EXK ko O. Ksrcji

Xkodij ljnkhci hjotjr (McJlj`)

= yjcrs (5113-511=)

Tkotjr (Njh-Bje) ^rcosktkgo (Lcr, Cpr, Ogv)con Xulljr (Lcy-Ght)

;=8 EXKs, 45% hglluokty, 41% Z^K

KUU sulljr vs wkotjr 3.53(;:% HK 3.32-3.5=) KUU sulljr vs trcos 3.3;(;:% HK 3.35-3.52)

Tktmko sjcsgos og tjlpjrcturj cssghkctkgo

BGU LGUJ KOBG...

Hmczco E. jt ci. Hiko Lkhrg Kobjht 5131


28/59

J. hgik EXK ko O. Ksrcji

BGU LGUJ KOBG...



29/59

J. hgik EXK ko Gilstjn Hguoty,

LO Xkodij hguoty

Lcyg Ljn Hjotjr con Gilstjn Ljn Hjotjr

3;;=-5114 Xulljr6 Fuoj-Xjpt

>23 EXK, :;% hglluokty, =1% 3Zrkoj

KUU sulljr vs gtmjr 3.8: (3.35-3.22) 4% kohrjcsj bgr jchm 31 njdrjj rksj ko tjlp

Nkn ogt cnfust bgr lgotm ko tjlp cociysksBGU LGUJ KOBG...

Ci-Mcsco jt ci. Hiko Lkhrg Kobjht 511;03:6;>4-;:1


30/59

J. hgik EXK ko Gilstjn Hguoty,

LO

BGU LGUJ KOBG...


Ujpjctjn cociysks ko Jotjrgechtjr (goiy 8= ksgictjs) con rjpgrtjn og sjcsgocikty


31/59

Echtjrjlkc Jodicon 511>-511=

BGU LGUJ KOBG...

Tkisgo F. jt ci. Hiko Lkhrg Kobjht 5131 (ko prjss)


32/59

@ijeskjiic EXK

> sktjs (Nurmcl, OH0 Lcrsjkiij, Brcohj0

Ljieguroj, Custrcikc con ^ckpjk, ^ckwco)

5113-5112

33=; EXK, 7 % hglluokty

KUU > wcrljst lgotms 3.>2 (3.1>-5.12)

Ucodjn brgl 3.>3 tg 3.>; ct > sktjs, cii p91.1: Jotjrgechtjr KUU < 3.55 (1.;5-3.28)

Xjrrctkc KUU < 3.58 (1.=2-3.44)

BGU LGUJ KOBG...

Conjrsgo N, jt ci. F Kobjht Nks 511=0 3;464:5-2


33/59

@ijeskjiic, > Hguotrkjs

C


34/59

@ijeskjiic, > Hguotrkjs Hglekojn

BGU LGUJ KOBG...

Conjrsgo N, jt ci. F Kobjht Nks 511=0 3;464:5-2


35/59

Tmct cegut

LUXC7 Umgnj Ksicon Mgspktci

Cii hikokhci LUXC

ksgictjs

Fcoucry 5113 tgLcrhm 5131

>=-mgur ruij

Qgkssgo rjdrjsskgo Gbbsjt igd # cnlkts

gr JN vkskts

BGU LGUJ KOBG...

Ljrlji IC jt ci. QIgX Goj, Lcrhm 513302(8)6j34;5:


36/59

Xjcsgocikty HC-LUXC

Qjnkctrkh pctkjots

3.=: tkljs (;:%HK 3.>:-5.82, p91.13)

ko qucrtjrs 8->

Cnuit pctkjots

3.3> tkljs (;:%HK 3.13-3.5;, p

BGU LGUJ KOBG...



37/59

Xjcsgocikty MC-LUXC

Qjnkctrkh pctkjots

5.;> tkljs (;:%HK 3.8;-2.53, p

Cnuit pctkjots

3.11 tkljs (;:%HK 1.=;-3.35, p

BGU LGUJ KOBG...



38/59

BGU LGUJ KOBG...



39/59

BGU LGUJ KOBG...



40/59

Xjcsgocikty con X. curju sLkxjn Kobjhtkgos, Echtjrjlkc, con Zppjr Jxtrjlkty Kobjhtkgos

BGU LGUJ KOBG...


X ikt n X`k K b tk


41/59

Xjcsgocikty con Xtcpmyig hghh us curjusX`ko Kobjhtkgos

BGU LGUJ KOBG...



42/59

Xjcsgoci con tjlpjrcturj-cssghkctjn kohrjcsjs ko

drcl-ojdctkvj echtjrkci

eiggnstrjcl kobjhtkgosclgod mgspktcikzjn pctkjots


43/59

Xjcsgocikty DOU, ZX 3;;;-5112

385 ZX Mgspktcis, ^XO Nctcecsj

Fco 3, 3;;; - Xjpt 81, 5112

Chkojtgechtjr spp, J. hgik, @. pojulgokcj,Q. cjrudkogscJotjrghghhus spp con X.

curjus

Lgotmiy hiklctj nctc6 Octkgoci Hiklchtkh

Nctc Hjotjrs Hiklctj Nctc Goikoj systjl

VKQ hgnj6 ljco tjlp, ljco njw pgkot,

tgtci prjhkpktctkgo


44/59

EXK ksgictjs

533,2;4 EXKs

;,>58 mgspktci-lgotms

X. curjus6 ljnkco ;42 EXK/lgotm Chkojtgechtjr6 ljnkco 24 EXK/lgotm

BGU LGUJ KOBG...

Jejr L jt ci. QIgX Goj. 513302(;)6j5:5;=. Jpue 5133 Xjp 52.
http://www.ncbi.nlm.nih.gov/pubmed/21966489http://www.ncbi.nlm.nih.gov/pubmed/21966489


45/59

Nkstrkeutkgo gb Mgspktcis ey Ujdkgo

BGU LGUJ KOBG...



46/59

Xjcsgociiy cnfustjn Hmcodj ko EXK

BGU LGUJ KOBG...


* Hgotrgiikod bgr igod-tjrl trjons, hjosus rjdkgo


47/59

EXK con ^jlpjrcturj

BGU LGUJ KOBG...


* Hgotrgiikod bgr igod-tjrl trjons, hjosus rjdkgo, prjhkpktctkgo con ljco rjictkvj mulknkty

EXK n M knkt


48/59

EXK con Mulknkty gr

Qrjhkpktctkgo

BGU LGUJ KOBG...Jejr L jt ci. QIgX Goj. 513302(;)6j5:5;=. Jpue 5133 Xjp 52.


49/59

Ljco Chkojtgechtjr EXK ey Lgotm

BGU LGUJ KOBG...



50/59

Ljco J. hgik EXK ey Lgotm

BGU LGUJ KOBG...



51/59

Ljco @. pojulgokc EXK ey Lgotm

BGU LGUJ KOBG...



52/59

Ljco Q. cjrudkogsc EXK ey Lgotm

BGU LGUJ KOBG...



53/59

Ljco EXK ey Lgotm bgr DQH

BGU LGUJ KOBG...

Jejr L jt ci. QIgX Goj. 513302(;)


54/59

Mkdm-Klpcht Fguroci Cssghkctj Jnktgr

Jvjo kb tmjrj ks sjcsgocikty gb cnlksskgos, con jvjo kbsuhm sjcsgocikty wjrj njjljn tg ej gb prchtkhci

klpgrtcohj, wmy smguin tmj hgrrjictkgo wktm tjlpjrcturj

ej gb vciuj7

Tmct ks tmj prchtkhci pueikh mjcitm skdokbkhcohj gb`ogwkod suhm hgrrjictkgo (ejygon tmj djojrci knjc tmct

oulejr gb hcsjs ks drjctjr ko sulljr hglpcrjn tg

wkotjr)

Xurjiy fust kohrjcskod survjkiicohj gb tcp wctjr qucikty ko

sulljr ks subbkhkjot dukncohj, rjdcrnijss gb jxcht

ctlgspmjrkh tjlpjrcturj

Jvjo kb wj bchjn c ojw khj cdj, surjiy pgpuictkgos

wguin ej ct rks` tg tmjsj pctmgdjos7

S36 Tmy wguin tjlpjrcturj


55/59

S36 Tmy wguin tjlpjrcturj

nctc ej gb vciuj7 Xjcsgos crj cssghkctjn wktm lcoy hmcodjs

kohiunkod stcbbkod hmcodjs (ojw kotjros),

vchctkgos con wjctmjr. Kb tjlpjrcturj wcs ogt

cssghkctjn wktm sjcsgoci pjc`s, wj wguin wcottg igg` ct gtmjr lgnkbkceij bchtgrs

Kb mkdmjr-tjlpjrcturjs crj prjnkhtjn,

survjkiicohj hguin ej citjrjn

Nctc go tjlpjrcturj con kohrjcsjn kobjhtkgoshguin kobgrl tmj digeci hiklctj hmcodj njectj

S b b


56/59

S56 Queikh mjcitm skdokbkhcohj gb `ogwkod

suhm sjcsgoci hgrrjictkgo7

Citjr survjkiicohj strctjdkjs

Hgst-jbbjhtkvjojsshguin tcrdjt DOU

survjkiicohj lgrj kotjoskvjiy ko sulljr

Citjr jlpkrkhci tmjrcpy njhkskgos

Ejdko gtmjr kovjstkdctkgos tg njtjrlkoj tmj

sgurhj gb jchm DOU ko sulljr tklj

Xurvjkiicohj

Xgurhj hgotrgi

S86 Fust kohrjcsj survjkiicohj


57/59

S86 Fust kohrjcsj survjkiicohj

gb tcp wctjr qucikty Ogoj gb tmjsj pctmgdjos mcvj ejjo

njtjhtjn ko kohrjcsjn brjqujohy ko gur tcp

wctjr

Cssghkctkgo hguin ej tmrgudm prgigodjnjovkrgoljotci hgotclkoctkgo gb mgspktcis,

hgigokzctkgo gb MHT mcons gr bglktjs

J. hgik hguin ej brgl sulljr ecrejhujhgg`guts gr kohrjcsj sjxuci chtkvkty - Z^K

S> J kb b n k i


58/59

S>6 Jvjo kb wj bchjn c ojw khj cdj, surjiy

pgpuictkgos wguin ej ct rks` tg tmjsj pctmgdjos7

K mcvj suelkttjn ly drcot tg ng c qucsk-

jxpjrkljotci stuny gb kobjhtkgos ejbgrj

con cbtjr co khj cdj

Kt cppjcrs tmct goiy jiklkoctkod c rks`bchtgr con cii cssghkctjn kobjhtkgos ks

wgrtmwmkij tmjo7

K nkscdrjj!


59/59

Ch`ogwijndljots

Cotmgoy Mcrrks

Fgo Buruog

Lcry-Hickrj Ugdmlcoo

Ncokji Lgrdco

@jrrk ^mgl

Ukhmcrn Rjojzkc

@rkstkj Fgmosgo

Hgiko Xtkoj

Ctiksc [guod

Iksc Qkojiks

Lkhmjiij Xmcrnjii

Lcrko Xhmwjkzjr

Mcoocm Ncy

@rkstjo @rjksji

Lcry Tcrrjo

Dwjo Xlktm

Lk`j Jejr

Fjsskoc LhDrjdgr

Uclcoco Icxlkocrcyco

seasonal variation in hospital pathogens - icpic 2011

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