Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Social Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
JMIR Public Health Surveill. 2021 Dec 7;7(12):e33296. doi: 10.2196/33296.
Many factors contribute to the spreading of hospital-acquired infections (HAIs).
This study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method.
In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs.
The mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected.
The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system.
许多因素导致医院获得性感染（HAI）的传播。
本研究旨在基于美国国家医疗保健安全网络（NHSN）方法，使用预测模型标准化伊朗的 HAI 率。
本研究使用伊朗医院感染监测系统（INIS）收集 HAI 患者（126314 例感染）的数据。此外，还使用医院统计和信息系统（AVAB）收集医院特征数据。首先，选择表现良好的医院，包括来自全国各地的 357 家医院。数据随机分为训练（70%）和测试（30%）集。最后，计算 HAI 的标准化感染比（SIR）和校正 SIR。
100110 例 HAI 患者的平均年龄为 40.02（SD 23.56）岁。基于观察到的和预测到的呼吸道感染（RTIs）、尿路感染（UTIs）、手术部位感染（SSIs）和血流感染（BSIs）的感染，校正 SIR 分别为 0.03（95%CI 0-0.09）、1.02（95%CI 0.95-1.09）、0.93（95%CI 0.85-1.007）和 0.91（95%CI 0.54-1.28）。此外，传染病、烧伤、妇产科和内科病房的 RTIs；烧伤、传染病、内科和重症监护病房的 UTIs；烧伤和传染病病房的 SSIs；以及大多数病房的 BSIs 的校正 SIR 均大于 1，这表明观察到的 HAI 多于预期。
本研究的结果有助于基于科学证据促进预防措施。它们还可以通过收集和系统分析 HAI 数据来不断改进监测系统，并通过建立基准系统鼓励医院更好地控制其感染率。
