新生儿重症监护病房中与医疗保健相关的感染的差异。
Disparities in Health Care-Associated Infections in the NICU.
机构信息
Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California.
California Perinatal Quality Care Collaborative, Palo Alto, California.
出版信息
Am J Perinatol. 2020 Jan;37(2):166-173. doi: 10.1055/s-0039-1688481. Epub 2019 Apr 30.
OBJECTIVES
This study aimed to examine multilevel risk factors for health care-associated infection (HAI) among very low birth weight (VLBW) infants with a focus on race/ethnicity and its association with variation in infection across hospitals.
STUDY DESIGN
This is a population-based cohort study of 20,692 VLBW infants born between 2011 and 2015 in the California Perinatal Quality Care Collaborative.
RESULTS
Risk-adjusted infection rates varied widely across neonatal intensive care units (NICUs), ranging from 0 to 24.6% across 5 years. Although Hispanic infants had higher odds of HAI overall, race/ethnicity did not affect the variation in infection rates. Non-Hispanic black mothers were more likely to receive care in NICUs within the top tertile of infection risk. Yet, among NICUs in this tertile, infants across all races and ethnicities suffered similar high rates of infection.
CONCLUSION
Hispanic infants had higher odds of infection. We found significant variation in infection across NICUs, even after accounting for factors usually associated with infection.
目的
本研究旨在探讨极低出生体重（VLBW）婴儿发生医疗保健相关性感染（HAI）的多水平风险因素，重点关注种族/民族及其与医院间感染差异的关联。
研究设计
这是一项基于人群的队列研究，纳入了 2011 年至 2015 年期间在加利福尼亚围产期质量护理合作组织中出生的 20692 名极低出生体重儿。
结果
风险调整后的感染率在新生儿重症监护病房（NICU）之间差异很大，5 年间从 0 到 24.6%不等。尽管西班牙裔婴儿总体上发生 HAI 的几率更高，但种族/民族并不影响感染率的差异。非西班牙裔黑人母亲更有可能在感染风险最高的 tertile 内的 NICU 接受治疗。然而，在该 tertile 的 NICU 中，所有种族和民族的婴儿都面临着相似的高感染率。
结论
西班牙裔婴儿感染的几率更高。我们发现 NICU 之间存在显著的感染差异，即使在考虑了通常与感染相关的因素后也是如此。
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