Korean Nosocomial Infections Surveillance System (KONIS) Report: Data Summary from April through June 2012

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Korean Nosocomial Infections Surveillance System (KONIS) Report: Data Summary from April through June 202 The Steering Committee of the Korean Nosocomial Infections Surveillance System Table. Characteristics of hospitals and intensive care participated in KONIS from April through June 202 Variables Number (%) Characteristics of hospitals Total no. of hospitals 65 university-affiliated hospitals 46(70.8) major teaching hospitals 50(76.9) private hospitals 55(84.6) Average no. of beds 778 Beds size 900 6(24.6) 700-899 2(32.3) 400-699 28(43.) Area Seoul 20(30.8) Kangwon/Gyeonggi/Incheon 20(30.8) Central/South 25(38.4) Hospitals with special ward Hemato-oncology 34(52.3) Bone marrow transplantation 27(4.5) Solid organ transplantation 3(20.0) Hemodialysis 63(96.9) Infectious Diseases Physician per hospital.4 Infection Control Professional per hospital.9 Beds per Infection Control Professional 42 Composition of intensive care (s) Total no. of s 3 Medical (M) 48(42.5) Medical combined (MC) 20(7.7) Surgical combined (SC) 2(0.6) Surgical (S) 7(5.0) Neurosurgical (NS) 6(4.2)

Table 2. means of nosocomial infection rates, by number of hospital beds, April through June 202 Nosocomial infection hospital beds rate 900 700-899 400-699 All 3 38 44 3 Patient-days 43,679 59,985 57,652 6,36 Infection rate * infections 83 266 92 64 mean 4.9 4.43 3.33 3.97 95% CI 3.62-4.84 3.93-5.00 2.89-3.84 3.68-4.29 UTI rate UTI 54 93 79 226 mean.24.55.37.40 95% CI 0.95-.6.27-.90.0-.7.23-.60 BSI rate BSI 94 4 66 274 mean 2.5.90.4.70 95% CI.76-2.63.58-2.28 0.90-.46.5-.9 PNEU rate PNEU 35 59 47 4 mean 0.80 0.98 0.82 0.87 95% CI 0.58-.2 0.76-.27 0.6-.09 0.74-.03 Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval. * ( UTIs, BSIs, or PNEUs / patient-days),000 ( UTIs / patient-days),000 ( BSIs / patient-days),000 ( PNEUs / patient-days),000 2

Table 3. means and percentiles of the distribution of device- associated infection rates, by number of hospital beds, April through June 202 Urinary catheter-associated UTI rate * hospital beds UTI Urinary catheterdays 900 3 53 38,638.37.05-.80 0 0 0.83.34.97 700-899 38 93 50,965.82.49-2.24 0 0.05 2.44 5.3 400-699 44 78 46,926.66.33-2.08 0 0.44 2.60 5.3 All 3 224 36,529.64.44-.87 0 0 0.92 2.5 5.05 Central line-associated BSI rate Central hospital beds BSI line-days 900 3 86 27,89 3.08 2.50-3.8 0 0.50 2.89 6.3 700-899 38 95 32,52 2.92 2.39-3.57 0 0 2.44 3.83 5.87 400-699 44 56 24,92 2.3.78-3.0 0 0.5 3.23 5.42 All 3 237 84,604 2.80 2.47-3.8 0 0.67 3.59 5.63 Ventilator-associated PNEU rate Ventilator hospital beds PNEU -days 900 3 20 2,783 0.92 0.59-.42 0 0 0.68 4.06 700-899 38 39 24,009.62.9-2.22 0 0 0 2.44 4.94 400-699 44 32 9,796.62.4-2.29 0 0 0 2.76 5.3 All 3 9 65,588.39.3-.70 0 0 0 2.09 4.52 Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval. * ( urinary catheter-associated UTIs / urinary catheter-days),000 ( central line-associated BSIs / central line-days),000 ( ventilator-associated PNEUs / ventilator-days),000 3

Table 4. means and percentiles of the distribution of device- utilization ratios, by number of hospital beds, April through June 202 Urinary catheter utilization ratio * hospital beds Urinary catheterdays Patientdays 900 3 38,638 43,679 0.88 0.877-0.883 0.80 0.85 0.88 0.94 0.99 700-899 38 50,965 59,985 0.85 0.847-0.853 0.66 0.78 0.89 0.94 0.98 400-699 44 46,926 57,652 0.8 0.807-0.83 0.64 0.73 0.83 0.94 0.98 All 3 36,529 6,36 0.85 0.848-0.852 0.67 0.78 0.88 0.94 0.98 Central line utilization ratio Central Patient- hospital beds line-days days 900 3 27,89 43,679 0.64 0.635-0.645 0.43 0.5 0.63 0.84 0.9 700-899 38 32,52 59,985 0.54 0.536-0.544 0.3 0.44 0.54 0.65 0.78 400-699 44 24,92 57,652 0.42 0.46-0.424 0.20 0.32 0.40 0.55 0.65 All 3 84,604 6,36 0.52 0.58-0.522 0.3 0.40 0.52 0.65 0.79 Ventilator utilization ratio Ventilator Patient- hospital beds -days days 900 3 2,783 43,679 0.50 0.495-0.505 0.26 0.32 0.46 0.63 0.73 700-899 38 24,009 59,985 0.40 0.396-0.404 0.22 0.29 0.37 0.54 0.64 400-699 44 9,796 57,652 0.34 0.336-0.344 0.4 0.22 0.33 0.43 0.57 All 3 65,588 6,36 0.4 0.408-0.42 0.9 0.27 0.37 0.54 0.65 Abbreviations: UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval. * ( urinary catheter-days / patient-days) ( central line-days / patient-days) ( ventilator-days / patient-days) 4

Table 5. means and percentiles of the distribution of device- associated infection rates, by type of, April through June 202 Urinary catheter-associated UTI rate * UTI Urinary catheterdays M 48 92 59,947.53.25-.88 0 0 0.88 2.4 4.25 MC 20 39 27,408.42.04-.95 0 0.54 0.97.96 4.95 SC 2 4 2,929.08 0.64-.83 0 0.4 0.90.84 2.5 S 7 34 8,786.8.29-2.53 0 0 0.90 3.7 5.07 NS 6 45 7,459 2.58.92-3.45 0 0.38 5.22 7.40 Central line-associated BSI rate Central BSI line-days M 48 2 38,52 2.9 2.42-3.50 0 0.82 4.24 5.66 MC 20 47 7,273 2.72 2.04-3.62 0 0.6 4.00 7.4 SC 2 6 7,569 2..30-3.45 0 0.76 2.87 7.9 S 7 45 2,099 3.72 2.78-4.98 0 0.50 4.3 7.5 NS 6 7 9,42.86.6-2.99 0 0 0.57 2.83 8.29 Ventilator-associated PNEU rate Ventilator PNEU -days M 48 3 34,449 0.90 0.63-.28 0 0 0.63 3.49 MC 20 7 2,085.4 0.87-2.26 0 0 0.4 2.45 4.35 SC 2 6 5,07 3.6.93-5.5 0 0 2.63 5.72 8.0 S 7 5 8,27 0.62 0.26-.48 0 0 0 0.99 2.23 NS 6 22 5,856 3.76 2.47-5.7 0 0 0.74 4.54 5.73 Abbreviations:, intensive care unit; M, medical ; MC, medical combined ; SC, surgical combined ; S, surgical ; NS, neurosurgical ; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval. * ( urinary catheter-associated UTIs / urinary catheter-days),000 ( central line-associated BSIs / central line-days),000 ( ventilator-associated PNEUs / ventilator-days),000 5

Table 6. means and percentiles of the distribution of device- utilization ratios, by type of, April through June 202 Urinary catheter utilization ratio * Urinary catheterdays Patientdays M 48 59,947 72,468 0.83 0.827-0.833 0.65 0.74 0.84 0.9 0.97 MC 20 27,408 32,477 0.84 0.836-0.844 0.69 0.79 0.87 0.93 0.95 SC 2 2,929 4,923 0.87 0.865-0.875 0.62 0.8 0.92 0.95 0.98 S 7 8,786 2,99 0.85 0.845-0.855 0.68 0.8 0.90 0.96 0.99 NS 6 7,459 9,457 0.90 0.896-0.904 0.79 0.86 0.90 0.98 0.99 Central line utilization ratio Central line-days Patient- days M 48 38,52 72,468 0.53 0.526-0.534 0.3 0.4 0.52 0.66 0.80 MC 20 7,273 32,477 0.53 0.525-0.535 0.30 0.39 0.5 0.72 0.84 SC 2 7,569 4,923 0.5 0.502-0.58 0.3 0.38 0.6 0.64 0.65 S 7 2,099 2,99 0.55 0.543-0.557 0.28 0.40 0.55 0.75 0.90 NS 6 9,42 9,457 0.47 0.463-0.477 0.2 0.33 0.5 0.58 0.70 Ventilator utilization ratio Ventilator -days Patient- days M 48 34,449 72,468 0.48 0.476-0.484 0.23 0.36 0.46 0.59 0.69 MC 20 2,085 32,477 0.37 0.365-0.375 0.6 0.22 0.37 0.53 0.65 SC 2 5,07 4,923 0.34 0.332-0.348 0.2 0.28 0.33 0.43 0.57 S 7 8,27 2,99 0.37 0.364-0.376 0.09 0.23 0.32 0.5 0.66 NS 6 5,856 9,457 0.30 0.294-0.306 0.6 0.24 0.29 0.36 0.42 Abbreviations:, intensive care unit; M, medical ; MC, medical combined ; SC, surgical combined ; S, surgical ; NS, neurosurgical ; UTI, urinary tract infection; BSI, bloodstream infection; PNEU, pneumonia; CI, confidence interval. * ( urinary catheter-days / patient-days) ( central line-days / patient-days) ( ventilator-days / patient-days) 6

Table 7. Number (%) of microorganisms isolated from clinical specimens of patients with nosocomial infections Organism Gram-positive cocci (%) 55 (24.3) isolates SUTI ASB UTI BSI PNU3 PNU2 PNU PNEU All 7 (63.6) 62 (26.2) 52 (52.) 2 (22.2) 35 (26.3) 37 (25.7) 25 (37.3) Staphylococcus aureus 8 9 49 2 32 34 92 Coagulase-negative staphylococci 5 6 35 42 Streptococcus species 2 2 4 6 Enterococcus faecalis 8 4 22 7 2 2 4 Enterococcus faecium 22 22 47 69 Enterococcus species Gram-positive bacilli (%) (0.4) (0.4) 5 (.7) 6 (0.9) Others 5 6 Gram-negative bacilli (%) 8 (35.9) 3 (27.3) 84 (35.4) 00 (34.2) (50.0) 7 (77.8) 96 (72.2) 04 (72.2) 288 (42.8) Escherichia coli 27 2 29 5 4 4 38 Klebsiella pneumoniae 3 3 9 20 20 42 Klebsiella oxytoca Citrobacter koseri 2 Enterobacter cloacae 2 3 3 5 Enterobacter aerogenes 2 2 3 Serratia marcescens 3 4 Proteus mirabilis 3 3 4 Citrobacter freundii Pseudomonas aeruginosa 24 25 8 2 6 8 5 Pseudomonas species Acinetobacter baumannii 9 9 52 5 49 55 6 Citrobacter braakii Stenotrophomonas maltophilia 9 9 Proteus penneri 2 2 2 Chryseobacterium species 3 3 Morganella morganii 2 Others 3 3 Fungi (%) 89 (39.4) (9.) 90 (38.0) 35 (2.0) (50.0) 2 (.5) 3 (2.) 28 (9.0) Candida albicans 35 36 9 2 2 47 Candida tropicalis 3 3 0 23 Candida glabrata 0 0 4 4 Candida parapsilosis 8 9 Candida species 4 4 2 6 Trichosporon asahii 2 2 2 Yeast 3 3 4 Aspergillus species Others 2 Total 226 237 292 2 9 33 44 673 7

Table 8. Susceptibilities of major pathogens isolated from patients with nosocomial infections resistant / Organism total isolates (%) Methicillin-resistant Staphylococcus aureus 78 / 9(85.7) Vancomycin-resistant Enterococcus faecalis / 39 (2.6) Vancomycin-resistant Enterococcus faecium 3 / 69 (44.9) Cefotaxime-resistant Escherichia coli 20 / 37 (54.) Cefotaxime-resistant Klebsiella pneumoniae 2 / 42 (50.0) Ciprofloxacin-resistant Escherichia coli 4 / 24 (58.3) Ciprofloxacin-resistant Klebsiella pneumoniae 3 / 26 (50.0) Imipenem-resistant Pseudomonas aeruginosa 6 / 49 (32.7) Imipenem-resistant Acinetobacter baumannii 99 / (89.2) 8