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利用实时定位系统进行接触者追踪:急诊科提高相对有效性的案例研究

Contact tracing with a real-time location system: A case study of increasing relative effectiveness in an emergency department.

作者信息

Hellmich Thomas R, Clements Casey M, El-Sherif Nibras, Pasupathy Kalyan S, Nestler David M, Boggust Andy, Ernste Vickie K, Marisamy Gomathi, Koenig Kyle R, Hallbeck M Susan

机构信息

Department of Emergency Medicine, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.

Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Department of Health Sciences Research, Mayo Clinic, Rochester, MN.

出版信息

Am J Infect Control. 2017 Dec 1;45(12):1308-1311. doi: 10.1016/j.ajic.2017.08.014. Epub 2017 Sep 28.

Abstract

BACKGROUND

Contact tracing is the systematic method of identifying individuals potentially exposed to infectious diseases. Electronic medical record (EMR) use for contact tracing is time-consuming and may miss exposed individuals. Real-time location systems (RTLSs) may improve contact identification. Therefore, the relative effectiveness of these 2 contact tracing methodologies were evaluated.

METHODS

During a pertussis outbreak in the United States, a retrospective case study was conducted between June 14 and August 31, 2016, to identify the contacts of confirmed pertussis cases, using EMR and RTLS data in the emergency department of a tertiary care medical center. Descriptive statistics and a paired t test (α = 0.05) were performed to compare contacts identified by EMR versus RTLS, as was correlation between pertussis patient length of stay and the number of potential contacts.

RESULTS

Nine cases of pertussis presented to the emergency department during the identified time period. RTLS doubled the potential exposure list (P < .01). Length of stay had significant positive correlation with contacts identified by RTLS (ρ = 0.79; P = .01) but not with EMR (ρ = 0.43; P = .25).

CONCLUSIONS

RTLS doubled the potential pertussis exposures beyond EMR-based contact identification. Thus, RTLS may be a valuable addition to the practice of contact tracing and infectious disease monitoring.

摘要

背景

接触者追踪是识别可能接触传染病个体的系统方法。使用电子病历(EMR)进行接触者追踪耗时且可能遗漏接触者。实时定位系统(RTLS)可能会改善接触者识别。因此,对这两种接触者追踪方法的相对有效性进行了评估。

方法

在美国百日咳疫情期间,于2016年6月14日至8月31日进行了一项回顾性病例研究,以确定确诊百日咳病例的接触者,使用三级医疗中心急诊科的EMR和RTLS数据。进行描述性统计和配对t检验(α = 0.05),以比较通过EMR与RTLS识别的接触者,以及百日咳患者住院时间与潜在接触者数量之间的相关性。

结果

在确定的时间段内,有9例百日咳病例到急诊科就诊。RTLS使潜在接触者名单增加了一倍(P < 0.01)。住院时间与通过RTLS识别的接触者有显著正相关(ρ = 0.79;P = 0.01),但与EMR无相关性(ρ = 0.43;P = 0.25)。

结论

RTLS识别出的潜在百日咳接触者比基于EMR的接触者追踪多出一倍。因此,RTLS可能是接触者追踪和传染病监测实践中的一项有价值的补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da35/7115342/90014bea8edf/ymic4561-fig-0001_lrg.jpg

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