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埃塞俄比亚东南部教学医院儿科患者医院获得性感染的发生率和危险因素:一项前瞻性研究。

Incidence and risk factors for hospital-acquired infection among paediatric patients in a teaching hospital: a prospective study in southeast Ethiopia.

机构信息

Department of Public Health, School of Health Science, Madda Walabu University, Bale Robe, Ethiopia

Department of Pediatrics, School of Medicine, Madda Walabu University, Bale Goba, Ethiopia.

出版信息

BMJ Open. 2020 Dec 17;10(12):e037997. doi: 10.1136/bmjopen-2020-037997.

Abstract

OBJECTIVES

In order to maximise the prevention of hospital-acquired infections (HAIs) and antimicrobial resistance, data on the incidence of HAIs are crucial. In Ethiopia, data about the occurrence of HAIs among hospitalised paediatric patients are lacking. We aim to determine the incidence and risk factors of HAIs among paediatric patients in Ethiopia.

DESIGN

A prospective cohort study.

SETTING

A teaching hospital in southeast Ethiopia.

PARTICIPANTS

448 hospitalised paediatric patients admitted between 1 November 2018 and 30 June 2019.

PRIMARY AND SECONDARY OUTCOME MEASURES

Incidence and risk factors of hospital-acquired infections.

RESULTS

A total of 448 paediatric patients were followed for 3227 patient days. The median age of the patients was 8 months (IQR: 2-26 months). The incidence rate of HAIs was 17.7 per 1000 paediatric days of follow-up; while the overall cumulative incidence was 12.7% (95% CI 9.8% to 15.8%) over 8 months. Children who stayed greater than 6 days in the hospital (median day) (adjusted risk ratio (RR): 2.58, 95% CI 1.52 to 4.38), and children with underlying disease conditions of severe acute malnutrition (adjusted RR: 2.83, 95% CI 1.61 to 4.97) had higher risks of developing HAIs.

CONCLUSIONS

The overall cumulative incidence of HAIs was about 13 per 100 admitted children. Length of stay in the hospital and underlying conditions of severe acute malnutrition were found to be important factors associated with increased risk of HAIs.

摘要

目的

为了最大程度地预防医院获得性感染(HAIs)和抗菌药物耐药性,HAIs 发生率的数据至关重要。在埃塞俄比亚,关于住院儿科患者发生 HAI 的数据尚不清楚。我们旨在确定埃塞俄比亚儿科患者 HAI 的发生率和危险因素。

设计

前瞻性队列研究。

地点

埃塞俄比亚东南部的一所教学医院。

参与者

2018 年 11 月 1 日至 2019 年 6 月 30 日期间住院的 448 名儿科患者。

主要和次要结果测量

医院获得性感染的发生率和危险因素。

结果

共对 448 名儿科患者进行了 3227 天的随访。患者的中位年龄为 8 个月(IQR:2-26 个月)。HAIs 的发病率为每 1000 名儿科随访日 17.7 例;而在 8 个月内,总累积发病率为 12.7%(95%CI 9.8%至 15.8%)。在医院停留超过 6 天的儿童(中位数天数)(校正后的风险比(RR):2.58,95%CI 1.52 至 4.38)和患有严重急性营养不良基础疾病的儿童(校正 RR:2.83,95%CI 1.61 至 4.97)发生 HAI 的风险更高。

结论

总体累积 HAI 发生率约为每 100 名入院儿童 13 例。住院时间和严重急性营养不良的基础状况被发现是与 HAI 风险增加相关的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a104/7747586/518673a30272/bmjopen-2020-037997f01.jpg

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