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医院获得性感染的预防:新冠疫情期间的一个概念。

Prevention of hospital-acquired infections: A construct during Covid-19 pandemic.

作者信息

Mitra Manasij, Ghosh Amrita, Pal Ranabir, Basu Maitraye

机构信息

Department of Anesthesiology, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India.

Department of Biochemistry, Medical College and Hospital, 88 College Street, Kolkata, West Bengal, India.

出版信息

J Family Med Prim Care. 2021 Sep;10(9):3348-3354. doi: 10.4103/jfmpc.jfmpc_742_21. Epub 2021 Sep 30.

Abstract

INTRODUCTION

Hospital-acquired infection (HAI) rates were reported to have declined in healthcare settings during the Covid-19 pandemic. Needless to mention that HAI is of paramount interest and relevance to a primary care physician who need to care from womb to tomb inside pandemic.

OBJECTIVES

This study was conducted to find the impact of Covid-19 pandemic on the four parameters of HAIs, namely, catheter-associated urinary tract infections (CAUTI), central-line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP) and surgical site infections (SSIs) with hand hygiene compliance rates among healthcare workers.

MATERIALS AND METHODS

This retrospective data mining was undertaken in a 700 bed multispecialty teaching hospital in the Eastern India which was a Government of Bihar approved speciality Covid Care Hospital. Data from the monthly routine infection control monitoring and surveillance activities was collated from January 2019 to December 2020. Control charts with upper and lower control limit set at mean ± 1 SD were used to monitor monthly trends of HAIs.

RESULTS

The CAUTI rates reduced by 28.01%; the CLABSI rates declined by 37.61%, the SSI rates reduced by 62.39%, while the highest VAP rates were reported in November 2019 (1.9 per 1000 ventilator days). The hand hygiene compliance rates from January 2019 to December 2020 among different healthcare staffs showed a sharply rising trend.

CONCLUSION

Covid-19 pandemic highlighted paramount importance regarding compliance to hand hygiene and implementation of standard infection control practices as recommended by World Health Organisation and Centres for Diseases Control and Prevention (CDC), which can drastically reduce range of HAIs.

摘要

引言

据报道,在新冠疫情期间,医疗机构中医院获得性感染(HAI)的发生率有所下降。毋庸置疑,对于在疫情期间需要全程照护患者的基层医疗医生而言,医院获得性感染至关重要且具有重要意义。

目的

本研究旨在探讨新冠疫情对医院获得性感染的四个参数的影响,即导尿管相关尿路感染(CAUTI)、中心静脉导管相关血流感染(CLABSI)、呼吸机相关性肺炎(VAP)和手术部位感染(SSI),以及医护人员的手卫生依从率。

材料与方法

本研究为回顾性数据挖掘,在印度东部一家拥有700张床位的多专科医院进行,该医院是比哈尔邦政府批准的新冠专科医院。收集了2019年1月至2020年12月每月常规感染控制监测活动的数据。使用上下控制限设定为均值±1标准差的控制图来监测医院获得性感染的月度趋势。

结果

导尿管相关尿路感染发生率降低了28.01%;中心静脉导管相关血流感染发生率下降了37.61%,手术部位感染发生率降低了62.39%,而2019年11月报告的呼吸机相关性肺炎发生率最高(每1000个呼吸机日1.9例)。2019年1月至2020年12月不同医护人员的手卫生依从率呈急剧上升趋势。

结论

新冠疫情凸显了遵守手卫生和实施世界卫生组织及疾病控制与预防中心(CDC)推荐的标准感染控制措施的至关重要性,这可大幅降低医院获得性感染的范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b5f/8565103/dc9c351c3b6d/JFMPC-10-3348-g001.jpg

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