Department of Internal Medicine, Armed Forces Medical College, Pune, India.
Department of Microbiology, Armed Forces Medical College, Pune, India.
Indian J Med Res. 2017 Jun;145(6):824-832. doi: 10.4103/ijmr.IJMR_1167_15.
BACKGROUND & OBJECTIVES: Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India.
A series of four cross-sectional point prevalence surveys were carried out between March and August 2014. Data of each patient admitted were collected using a structured data entry form. Centers for Disease Control and Prevention guidelines were used to identify and diagnose patients with HAI.
Overall prevalence of HAI was 3.76 per cent. Surgical Intensive Care Unit (ICU) (25%), medical ICU (20%), burns ward (20%) and paediatric ward (12.17%) were identified to have significant association with HAI. Prolonged hospital stay [odds ratio (OR=2.81), mechanical ventilation (OR=18.57), use of urinary catheter (OR=7.89) and exposure to central air-conditioning (OR=8.59) had higher odds of acquiring HAI (P<0.05).
INTERPRETATION & CONCLUSIONS: HAI prevalence showed a progressive reduction over successive rounds of survey. Conscious effort needs to be taken by all concerned to reduce the duration of hospital stay. Use of medical devices should be minimized and used judiciously. Healthcare infection control should be a priority of every healthcare provider. Such surveys should be done in different healthcare settings to plan a response to reducing HAI.
医院获得性感染(HAI)是患者安全的主要挑战,对患者的生活质量产生严重影响,有时导致残疾甚至死亡,对公共卫生具有重大影响。HAI 的真实负担仍然未知,特别是在发展中国家。本研究旨在估计印度浦那一家三级护理医院的 HAI 现患率,并研究其相关危险因素。
2014 年 3 月至 8 月间进行了一系列四项横断面现患率调查。使用结构化数据输入表收集每位入院患者的数据。使用疾病控制和预防中心的指南来识别和诊断 HAI 患者。
HAI 的总现患率为 3.76%。外科重症监护病房(25%)、内科重症监护病房(20%)、烧伤病房(20%)和儿科病房(12.17%)与 HAI 有显著关联。住院时间延长(比值比 [OR] = 2.81)、机械通气(OR = 18.57)、使用导尿管(OR = 7.89)和暴露于中央空调(OR = 8.59)的患者发生 HAI 的几率更高(P<0.05)。
HAI 的现患率在连续几轮调查中呈逐渐下降趋势。所有相关人员都应努力减少住院时间。应尽量减少医疗设备的使用,并明智地使用。医疗保健感染控制应成为每位医疗保健提供者的优先事项。应在不同的医疗保健环境中进行此类调查,以计划减少 HAI 的应对措施。