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埃塞俄比亚阿姆哈拉地区两家教学医院的医院获得性感染现患率。

Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia.

作者信息

Yallew Walelegn Worku, Kumie Abera, Yehuala Feleke Moges

机构信息

Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar.

School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa.

出版信息

Drug Healthc Patient Saf. 2016 Aug 23;8:71-6. doi: 10.2147/DHPS.S107344. eCollection 2016.

Abstract

PURPOSE

Hospital-acquired infection (HAI) is a major safety issue affecting the quality of care of hundreds of millions of patients every year, in both developed and developing countries, including Ethiopia. In Ethiopia, there is no comprehensive research that presents the whole picture of HAIs in hospitals. The objective of this study was to examine the nature and extent of HAIs in Ethiopia.

METHODS

A repeated cross-sectional study was conducted in two teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. The survey was conducted in dry and wet seasons of Ethiopia, that is, in March to April and July 2015. Physicians and nurses collected the data according to the Centers for Disease Control and Prevention definition of HAIs. Coded and cleaned data were transferred to SPSS 21 and STATA 13 for analysis. Univariate and multivariable logistic regression analyses were used to examine the prevalence of HAIs and relationship between explanatory and outcome variables.

RESULTS

A total of 908 patients were included in this survey, the median age of the patients was 27 years (interquartile range: 16-40 years). A total of 650 (71.6%) patients received antimicrobials during the survey. There were 135 patients with HAI, with a mean prevalence of 14.9% (95% confidence interval 12.7-17.1). Culture results showed that Klebsiella spp. (22.44%) and Staphylococcus aureus (20.4%) were the most commonly isolated HAI-causing pathogens in these hospitals. The association of patient age and hospital type with the occurrence of HAI was statistically significant.

CONCLUSION

It was observed that the prevalence of HAI was high in the teaching hospitals. Surgical site infections and pneumonia were the most common types of HAIs. Hospital management should give more attention to promoting infection prevention practice for better control of HAIs in teaching hospitals.

摘要

目的

医院获得性感染(HAI)是一个重大的安全问题,每年影响着发达国家和发展中国家(包括埃塞俄比亚)数亿患者的医疗质量。在埃塞俄比亚,尚无全面研究展示医院HAI的整体情况。本研究的目的是调查埃塞俄比亚HAI的性质和程度。

方法

在两家教学医院开展了一项重复横断面研究。纳入所有在调查当天入院至少48小时的符合条件的住院患者。调查于埃塞俄比亚的旱季和雨季进行,即2015年3月至4月以及7月。医生和护士根据美国疾病控制与预防中心对HAI的定义收集数据。经过编码和清理的数据被传输到SPSS 21和STATA 13进行分析。使用单变量和多变量逻辑回归分析来检查HAI的患病率以及解释变量与结果变量之间的关系。

结果

本调查共纳入908名患者,患者的中位年龄为27岁(四分位间距:16 - 40岁)。共有650名(71.6%)患者在调查期间接受了抗菌药物治疗。有135例HAI患者,平均患病率为14.9%(95%置信区间12.7 - 17.1)。培养结果显示,克雷伯菌属(22.44%)和金黄色葡萄球菌(20.4%)是这些医院中最常分离出的导致HAI的病原体。患者年龄和医院类型与HAI发生之间的关联具有统计学意义。

结论

观察到教学医院中HAI的患病率较高。手术部位感染和肺炎是最常见的HAI类型。医院管理应更加重视促进感染预防措施,以更好地控制教学医院中的HAI。

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