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基层医疗机构病房中医疗保健相关性感染的现患率及危险因素。

Point prevalence and risk factors for healthcare-associated infections in primary healthcare wards.

机构信息

Department of Infection Control, Oulu University Hospital, Oulu, Finland.

出版信息

Infection. 2011 Jun;39(3):217-23. doi: 10.1007/s15010-011-0123-7. Epub 2011 May 15.

DOI:10.1007/s15010-011-0123-7
PMID:21573945
Abstract

PURPOSE

The aim of this study was to document the point prevalence of healthcare-associated infections (HAIs) in the public primary healthcare wards, which treat both acute and long-term care patients. We also assessed the risk factors for HAI and the consumption of alcoholic hand rubs and antibiotics.

METHODS

A cross-sectional study was performed in northern Finland in 2006 including all healthcare centers in the Oulu University Hospital district.

RESULTS

There were 1,190 patients eligible for study in 44 public primary healthcare wards. The point prevalence of HAIs was 10.1%. The most common infections were urinary tract infections (30%), lower respiratory tract infections (27%), and skin and soft tissue infections (20%). The prevalence of HAIs did not depend on whether wards gave acute care, long-term care, or both acute and long-term care. In the multivariate analysis, the main risk factors for HAI were: more than three antibiotic prescriptions during the previous year, fully bedridden, renal disease, venous catheter, age over 80 years, previous hospitalization during the past six months, and implanted foreign material. A prophylactic antibiotic was a protecting factor. Antimicrobial treatment was given for 18% of the study population and another 18% received prophylactic antimicrobials.

CONCLUSIONS

HAIs are common in Finnish primary healthcare wards and there is a need to improve everyday practices in the wards in order to reduce the number of HAIs. It is also important to reduce the inappropriate use of antibiotics.

摘要

目的

本研究旨在记录公共初级保健病房(同时治疗急性和长期护理患者)中获得性医院感染(HAI)的现患率。我们还评估了 HAI 的危险因素以及酒精擦手液和抗生素的消耗情况。

方法

2006 年,在芬兰北部进行了一项横断面研究,包括奥卢大学医院区的所有医疗中心。

结果

在 44 个公共初级保健病房中,有 1190 名符合研究条件的患者。HAI 的现患率为 10.1%。最常见的感染是尿路感染(30%)、下呼吸道感染(27%)和皮肤软组织感染(20%)。HAI 的患病率与病房提供急性护理、长期护理或两者兼而有之无关。在多变量分析中,HAI 的主要危险因素是:过去一年中抗生素处方超过 3 张、完全卧床、肾脏疾病、静脉导管、年龄超过 80 岁、过去六个月内住院治疗以及植入的异物。预防性使用抗生素是一种保护因素。研究人群中有 18%接受了抗菌治疗,另有 18%接受了预防性抗菌治疗。

结论

芬兰初级保健病房的 HAI 很常见,需要改善病房的日常实践,以减少 HAI 的发生。减少抗生素的不合理使用也很重要。

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