2010年至2016年苏格兰半侵入性超声检查后的感染风险：一项使用全国关联数据集的回顾性队列研究。
Risk of infection following semi-invasive ultrasound procedures in Scotland, 2010 to 2016: A retrospective cohort study using linked national datasets.
作者信息
Scott David, Fletcher Eilidh, Kane Hayley, Malcolm William, Kavanagh Kimberley, Banks A-Lan, Rankin Annette
机构信息
Bristol Dental School, University of Bristol, Bristol, UK.
Information Services Division, NHS National Services Scotland, Edinburgh, UK.
出版信息
Ultrasound. 2018 Aug;26(3):168-177. doi: 10.1177/1742271X18774594. Epub 2018 May 3.
INTRODUCTION
Outbreak reports indicate a risk of cross-infection following medical procedures using semi-invasive ultrasound probes. This study aimed to evaluate the risk of infection, using microbiological reports and antibiotic prescriptions as proxy measures, associated with semi-invasive ultrasound probe procedures, including transoesophageal echocardiography, transvaginal and transrectal ultrasound.
METHODS
Patient records from the Electronic Communication of Surveillance in Scotland and the Prescribing Information System were linked with the Scottish Morbidity Records for cases in Scotland between 2010 and 2016. Three retrospective cohorts were created to include inpatients/day-cases and outpatients in the following specialties: Cardiology, Gynaecology and Urology. Cox regression was used to quantify the association between semi-invasive ultrasound probe procedures and the risk of positive microbiological reports and community antibiotic prescriptions in the 30-day period following the procedure.
RESULTS
There was a greater hazard ratio of microbiological reports for patients who had undergone transoesophageal echocardiography (HR: 4.92; 95% CI: 3.17-7.63), transvaginal (HR: 1.41; 95% CI: 1.21-1.64) and transrectal ultrasound (HR: 3.40; 95% CI: 2.90-3.99), compared with unexposed cohort members after adjustment for age, co-morbidities, previous hospital admissions and past care home residence. Similarly, there was a greater hazard ratio of antibiotic prescribing for those who had received transvaginal (HR: 1.26; 95% CI: 1.20-1.32) and transrectal (HR: 1.75; 95% CI: 1.66-1.84) ultrasound, compared with unexposed patients.
CONCLUSION
Analysis of linked national datasets demonstrated a greater risk of infection within 30 days of undergoing semi-invasive ultrasound probe procedures, using microbiological reports and antibiotic prescriptions as proxy measures of infection.
引言
疫情报告显示，使用半侵入式超声探头进行医疗程序后存在交叉感染风险。本研究旨在利用微生物学报告和抗生素处方作为替代指标，评估与半侵入式超声探头程序（包括经食管超声心动图、经阴道和经直肠超声）相关的感染风险。
方法
将苏格兰电子监测通信系统和处方信息系统中的患者记录与2010年至2016年期间苏格兰发病率记录中的病例相链接。创建了三个回顾性队列，纳入以下专科的住院患者/日间病例和门诊患者：心脏病学、妇科和泌尿外科。使用Cox回归来量化半侵入式超声探头程序与术后30天内微生物学报告阳性风险和社区抗生素处方之间的关联。
结果
与在调整年龄、合并症病史、既往住院史和既往养老院居住史后未暴露队列成员相比，接受经食管超声心动图检查（风险比：4.92；95%置信区间：3.17 - 7.63）、经阴道超声检查（风险比：1.41；95%置信区间：1.21 - 1.64）和经直肠超声检查（风险比：3.40；95%置信区间：2.90 - 3.99）的患者微生物学报告的风险比更高。同样，与未暴露患者相比，接受经阴道超声检查（风险比：1.26；95%置信区间：1.ii0 - 1.32）和经直肠超声检查（风险比：1.75；95%置信区间：1.66 - 1.84）的患者抗生素处方的风险比更高。
结论
利用微生物学报告和抗生素处方作为感染的替代指标，对全国关联数据集的分析表明，在进行半侵入式超声探头程序后30天内感染风险更高。
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