环境卫生与医院感染的时间序列研究:基于广义相加模型(GAM)
作者:
作者单位:

1.浙江大学公共卫生学院;2.浙江医院医院感染管理科;3.浙江医院微生物实验室;4.浙江省疾病预防控制中心免疫规划所

作者简介:

通讯作者:

陈坤  E-mail: ck@zju.edu.cn

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基金项目:

浙江省医药卫生科技计划项目(2021KY625)


Environmental hygiene and healthcare-associated infection: a time-series study based on generalized additive model
Author:
Affiliation:

1.School of Public Health, Zhejiang University, Hangzhou 310058, China;2.Department of Healthcare-associa-ted Infection Management, Zhejiang Hospital, Hangzhou 310058, China;3.Microbiology Laboratory, Zhejiang Hospital, Hangzhou 310058, China;4.Immunization Program Institute, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310052, China

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    摘要:

    目的 定量分析环境卫生对医院感染发生的影响。 方法 收集某三甲医院2018年1月—2022年12月医院感染与环境卫生学监测资料,采用时间序列的广义相加模型分析环境检出菌落形成单位(CFU)对医院感染发生的影响。 结果 单污染模型显示,医院感染与工作人员手细菌菌落数之间存在显著正相关性(β1=0.009, P=0.012),工作人员手月度平均菌落形成单位(MCFU/Dish)每升高1个四分位数间距(IQR),医院感染发生率增加13.28%(95%CI:2.82%~24.81%);亚组分析与滞后效应分析显示,工作人员手月度MCFU/Dish(卫生手消毒后)升高1个IQR,当月(lag0)医院感染超额风险(ER)为16.26%(95%CI:15.45%~17.09%)。多污染模型中,物体表面污染与医院感染的相关性同样具有统计学意义。 结论 医院环境卫生与医院感染之间存在显著相关性。

    Abstract:

    Objective To quantitatively analyze the impact of environmental hygiene on the occurrence of healthcare-associated infections (HAI). Methods Monitoring data of HAI and environmental hygiene from a tertiary first-class hospital from January 2018 to December 2022 were collected, and the impact of environmental bacterial colony forming unit (CFU) on the occurrence of HAI was analyzed by a time-series generalized additive model. Results The single-contamination model showed a significant positive correlation between HAI and staff's hand bacterial CFU (β1=0.009, P=0.012). For an increase of 1 interquartile range (IQR) in the monthly mean CFU per dish (MCFU/Dish) of staffs' hand, the incidence of HAI increased by 13.28% (95%CI: 2.82%-24.81%). Subgroup and lag effect analysis showed that when the monthly MCFU/Dish (after hand disinfection) of staffs' hand increased by one IQR, the excess risk (ER) of HAI for the month (lag0) was 16.26% (95%CI: 15.45%-17.09%). In the multi-contamination model, the correlation between surface contamination and HAI was also statistically significant. Conclusion There is a significant correlation between hospital environmental hygiene and the occurrence of HAI.

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引用本文

林凯,陈坤,王建炳,等.环境卫生与医院感染的时间序列研究:基于广义相加模型(GAM)[J]. 中国感染控制杂志,2024,23(7):798-805. DOI:10.12138/j. issn.1671-9638.20245324.
LIN Kai, CHEN Kun, WANG Jian-bing, et al. Environmental hygiene and healthcare-associated infection: a time-series study based on generalized additive model[J]. Chin J Infect Control, 2024,23(7):798-805. DOI:10.12138/j. issn.1671-9638.20245324.

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  • 收稿日期:2023-12-12
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  • 在线发布日期: 2024-08-13
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