多中心研究中手术部位感染的发生率——对监测实践和组织的影响。
Incidence of Surgical Site Infections in Multicenter Study-Implications for Surveillance Practice and Organization.
机构信息
Chair of Microbiology, Jagiellonian University Medical College, Czysta Str. 18, 31-121 Krakow, Poland.
Institute of Economics, Finance and Management, Faculty of Management and Social Communication, Jagiellonian University, 30-348 Krakow, Poland.
出版信息
Int J Environ Res Public Health. 2021 May 18;18(10):5374. doi: 10.3390/ijerph18105374.
INTRODUCTION
WHO core components of healthcare-associated infections (HAIs) prevention and control include their surveillance system. In Poland, there are no widespread multi-center infection surveillance networks based on continuous, targeted, active methodology. One of the most important form of HAIs are surgical site infections (SSIs). The aim of this study was to analyze the incidence of SSIs, in the context of seasonal differentiation. Seasonal differentiation could be connected with weather conditions, but it also can be affected by personnel absence due to holidays and furlough. The second aspect may influence organization of work and increased absenteeism may contribute to lowering the quality of patient care. Healthcare associated infections are the phenomenon which can be especially affected by such factors.
METHODS
The data used originate from the targeted, active surveillance reports obtained from the six years period, based on the ECDC recommendations.
RESULTS
Highest incidence rates of SSIs were found after operations performed in June and August, equal to 1.8% and 1.5% respectively and the lowest in October was 0.8%. These differences were statistically significant: for June incidence: OR 1.6, 95% CI 1.03-2.5, = 0.015. Another approach showed a significant difference between the level of incidence in the period from November to January together with from June to August (1.35%), comparing to the rest of the year (1.05%). Also the rates of enterococcal and Enterobacterales infections were significantly higher for the period comprising months from November till January and from June to August. In Poland these are periods of increased number of absences associated with summer, national and religious holidays.
CONCLUSIONS
Our results show that the short-term surveillance data limited to several days or months are not sufficient to obtain a valuable description of the epidemiological situation due to HAI. Efforts should be undertaken in order to implement wide net of hospital acquired infections, including SSI on the country level.
简介
世界卫生组织（WHO）的医疗保健相关感染（HAI）预防和控制的核心组成部分包括其监测系统。在波兰，没有基于连续、有针对性、主动方法的广泛多中心感染监测网络。HAI 中最重要的形式之一是手术部位感染（SSI）。本研究的目的是分析 SSI 的发生率，并根据季节性差异进行分析。季节性差异可能与天气条件有关，但也可能受到因假期和休假而导致人员缺勤的影响。第二个方面可能会影响工作组织，缺勤增加可能会降低患者护理质量。HAI 是一种特别受这些因素影响的现象。
方法
使用的数据源自基于 ECDC 建议的六年期间的有针对性、主动监测报告。
结果
SSI 的发生率最高的是 6 月和 8 月进行的手术，分别为 1.8%和 1.5%，而 10 月最低，为 0.8%。这些差异具有统计学意义：对于 6 月的发生率：OR 1.6，95%CI 1.03-2.5，=0.015。另一种方法显示，与 11 月至 1 月和 6 月至 8 月期间相比，11 月至 1 月和 6 月至 8 月期间的发病率差异显著（1.35%），与一年中的其他时间（1.05%）相比。肠球菌和肠杆菌科感染的发生率在包括 11 月至 1 月和 6 月至 8 月的月份期间也明显更高。在波兰，这些是与夏季、国家和宗教假期相关的缺勤人数增加的时期。
结论
我们的结果表明，由于 HAI，短期监测数据仅限于几天或几个月，不足以对流行病学情况进行有价值的描述。应努力在全国范围内实施广泛的医院获得性感染网络，包括 SSI。
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