医院和医疗服务提供者的患者数量、剖宫产率以及产后早期侵袭性耐甲氧西林金黄色葡萄球菌感染。
Hospital and provider patient volumes, cesarean section rates, and early postpartum invasive methicillin-resistant Staphylococcus aureus infection.
机构信息
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA.
Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA.
出版信息
Am J Infect Control. 2014 Feb;42(2):156-9. doi: 10.1016/j.ajic.2013.08.003. Epub 2013 Dec 19.
OBJECTIVE
We sought to examine whether hospital and provider volumes and cesarean section rates influenced early postpartum invasive methicillin-resistant Staphylococcus aureus (MRSA) infection.
METHODS
We used data from the Nationwide Inpatient Sample, a representative sample of US community hospitals. Multivariate hierarchical regression models were used to estimate odds ratios adjusted for hospital total discharges, nurse:patient ratio, urbanicity, teaching status, bed size, ownership, and geographic region and patient age, race, expected payer, and comorbidities.
RESULTS
The total sample size for the hospital analysis was 3,487,350 deliveries, which included 555 cases of MRSA infection. The total sample size for the provider analysis was 1,186,703 deliveries, with 221 cases of MRSA infection. Hospital and provider patient (deliveries) volumes and cesarean section rates were not associated with early postpartum invasive MRSA infection.
CONCLUSIONS
Barring major bias in our estimates, our results suggest that transmission from providers may not be a predominant route of postpartum MRSA infection in US hospitals.
目的
我们旨在探讨医院和医生的数量及剖宫产率是否会影响产后早期侵袭性耐甲氧西林金黄色葡萄球菌（MRSA）感染。
方法
我们使用了来自全美住院患者样本（Nationwide Inpatient Sample）的数据，这是美国社区医院的代表性样本。我们采用多变量层次回归模型，根据医院总出院人数、护士与患者比例、城市性、教学状态、床位数、所有权和地理位置以及患者年龄、种族、预期支付者和合并症，对调整后的优势比进行了估计。
结果
医院分析的总样本量为 3487350 例分娩，其中包括 555 例 MRSA 感染病例。医生分析的总样本量为 1186703 例分娩，其中包括 221 例 MRSA 感染病例。医院和医生的患者（分娩）数量及剖宫产率与产后早期侵袭性 MRSA 感染无关。
结论
除非我们的估计存在重大偏差，否则我们的研究结果表明，在美国医院中，MRSA 感染的传播可能并非主要来自于医护人员。
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