Service d'Hygiène, Epidémiologie et Prévention, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
J Hosp Infect. 2009 Nov;73(3):217-24. doi: 10.1016/j.jhin.2009.07.018. Epub 2009 Sep 27.
This study aimed to correlate nosocomial bloodstream infections (NBIs) across time against the ecological effect of infection control activities. All patients hospitalised >or=48h in the haematology and intensive care departments of a university hospital and discharged between 1 January 2004 and 30 June 2006 were prospectively included. The case definition of NBI infection was: (1) at least one positive blood culture justified by clinical signs, or (2) at least two positive blood cultures when the micro-organism was one of the following: coagulase-negative staphylococci, Bacillus spp. (except Bacillus anthracis), Corynebacterium spp., Propionibacterium spp., Micrococcus spp., or other commensal with similar pathogenicity, if occurring >or=48h after patient admission. NBI incidences were correlated in quarterly intervals using Spearman's test and linear regression. In total, 3829 patients accounting for 46 474 patient-days at risk were included. We identified 101 NBIs in intensive care and 286 NBIs in haematology. There was a correlation between NBI incidence in haematology with the NBI incidence in intensive care (r=0.68, P=0.042). The linear model for NBI incidences between departments was R(2)=0.52, with a positive trend (P=0.029). A common determinant such as improved hygiene measures is the most likely reason for this association.
本研究旨在通过感染控制活动的生态效应来关联医院获得性血流感染（NBI）随时间的变化。所有在大学医院血液科和重症监护病房住院时间超过 48 小时并于 2004 年 1 月 1 日至 2006 年 6 月 30 日出院的患者均被前瞻性纳入。NBI 感染的病例定义为：（1）至少有一次阳性血培养，由临床症状证实，或（2）至少两次阳性血培养，当微生物为以下一种时：凝固酶阴性葡萄球菌、芽孢杆菌属（炭疽芽孢杆菌除外）、棒状杆菌属、丙酸杆菌属、微球菌属或其他具有相似致病性的共生菌，如果在患者入院后 48 小时以上发生。使用 Spearman 检验和线性回归在季度间隔内关联 NBI 发生率。共纳入 3829 例患者，共计 46474 人日风险。我们在重症监护室中发现了 101 例 NBI，在血液科中发现了 286 例 NBI。血液科 NBI 发生率与重症监护室 NBI 发生率之间存在相关性（r=0.68，P=0.042）。部门之间 NBI 发生率的线性模型为 R（2）=0.52，呈正相关（P=0.029）。这种关联最可能的原因是共同的决定因素，如改善的卫生措施。
