Brusaferro S, Regattin L, Silvestro A, Vidotto L
Department of Experimental and Clinical Pathology and Medicine, School of Medicine, University of Udine, Udine, Italy.
J Hosp Infect. 2006 Jun;63(2):211-5. doi: 10.1016/j.jhin.2006.01.012. Epub 2006 Apr 5.
This study presents results from a six-month prospective surveillance of hospital-acquired infections in four Italian long-term-care facilities (LTCFs). Eight hundred and fifty-nine patients were enrolled and 21 503 person-days were observed. Two hundred and fifty-four hospital-acquired infections (HAIs) occurred in 188 patients. The overall infection rate was 11.8 per 1000 person-days. The most frequent infections were urinary tract infections (3.2 per 1000 person-days), lower respiratory tract infections (2.7 per 1000 person-days) and skin infections (2.5 per 1000 person-days). Risks related to HAI in a multi-variate regression model were: length of stay >or=28 days [odds ratio (OR) 3.5, 95% confidence intervals (CI) 2.4-5.0]; presence of a device (OR 2.0, 95%CI 1.3-3.0); Norton scale <12 (OR 1.8, 95%CI 1.2-2.6); and being bedridden (OR 1.7, 95%CI 1.08-2.6). The presence of HAI increased the median length of stay (31 days vs 20 days, P<0.01) without a significant influence on fatal outcome (OR 1.4, 95%CI 0.7-2.7).
本研究展示了对意大利四个长期护理机构（LTCFs）医院获得性感染进行的为期六个月的前瞻性监测结果。共纳入859名患者，观察了21503人日。188名患者发生了254例医院获得性感染（HAIs）。总体感染率为每1000人日11.8例。最常见的感染是尿路感染（每1000人日3.2例）、下呼吸道感染（每1000人日2.7例）和皮肤感染（每1000人日2.5例）。多变量回归模型中与医院获得性感染相关的风险因素为：住院时间≥28天[比值比（OR）3.5，95%置信区间（CI）2.4 - 5.0]；使用医疗器械（OR 2.0，95%CI 1.3 - 3.0）；诺顿量表评分<12（OR 1.8，95%CI 1.2 - 2.6）；以及卧床不起（OR 1.7，95%CI 1.08 - 2.6）。医院获得性感染的存在增加了中位住院时间（31天对20天，P<0.01），但对死亡结局无显著影响（OR 1.4，95%CI 0.7 - 2.7）。
