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2016-2020 年,埃塞俄比亚西北部贡德尔大学综合专科医院住院成年慢性病患者医院感染的发生率及决定因素。

Incidence and determinants of nosocomial infection among hospital admitted adult chronic disease patients in University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia, 2016-2020.

机构信息

Health Field Officer at the International Committee of the Red Cross, Gondar, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Front Public Health. 2023 Feb 24;11:1087407. doi: 10.3389/fpubh.2023.1087407. eCollection 2023.

Abstract

BACKGROUND

Nosocomial infections are major public health problem which affects more than 100 million patients each year globally. This leads to prolonged hospital stays, a high mortality rate, and a vast financial burden to the healthcare system as well as the patients. This study aimed to find out the incidence of nosocomial infections and determinant factors among admitted adult chronic illness patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

An institutional-based retrospective follow-up study design was employed among 597 respondents. The secondary data was collected from April 15 to May 15, 2021. A computer-generated random sampling technique was used to select a total of 599 patients using Open-epi software. Structured checklists were used to collect data. For data entry and analysis Epi-Data version 4.6 and STATA 16 were used respectively. To identify statistically significant variables Cox-regressions (univariable and multivariable) were performed. To declare statistically significant variables based on < 0.05 in the multivariable Cox-regression model, adjusted hazard ratio with 95% CI was used.

RESULTS

A total of 597(99.6%) adult chronic illness patients were included in the study. Of these, 53 (8.88%) participants developed nosocomial infections and the incidence rate of nosocomial infection was 6.6 per 1,000 person-days observation. In this study, not taking antibiotics (AHR = 2.74, 95% CI: 1.49, 5.04), using mechanical ventilation (AHR = 2.67, 95% CI: 1.36, 5.26), being on urinary catheter (AHR = 4.62, 95% CI: 2.22, 9.65), being on intravenous catheter (AHR = 3.42, 95% CI: 1.22, 9.61) and length of hospital stay >20 days (AHR = 2.66, 95% CI: 1.43, 4.94) were significantly associated with nosocomial infections.

CONCLUSIONS

The findings have indicated that the incidence of nosocomial infection was low. No taking antibiotics, intravenous insertion, mechanical ventilation, length of hospital stay, and urinary catheterization were the predictors for the development of nosocomial infection. Therefore, we recommend that the healthcare providers need to give emphasis on infection prevention and control in the institution on these factors that have a significant effect on nosocomial infection.

摘要

背景

医院感染是一个严重的公共卫生问题,全球每年影响超过 1 亿患者。这导致住院时间延长、死亡率高,并给医疗系统和患者带来巨大的经济负担。本研究旨在探讨埃塞俄比亚西北部贡德尔大学综合专科医院成年慢性病患者医院感染的发生率和决定因素。

方法

采用基于机构的回顾性随访研究设计,对 597 名受访者进行研究。2021 年 4 月 15 日至 5 月 15 日期间收集了二次数据。使用 Open-epi 软件,采用计算机生成的随机抽样技术共抽取了 599 名患者。使用结构化检查表收集数据。Epi-Data 版本 4.6 和 STATA 16 分别用于数据录入和分析。采用 Cox 回归(单变量和多变量)来确定有统计学意义的变量。根据多变量 Cox 回归模型中<0.05 的变量,采用调整后的危险比和 95%置信区间来确定有统计学意义的变量。

结果

共有 597 名(99.6%)成年慢性病患者纳入研究。其中,53 名(8.88%)患者发生医院感染,医院感染发生率为 6.6/1000 人日观察。在这项研究中,未使用抗生素(AHR = 2.74,95%CI:1.49,5.04)、使用机械通气(AHR = 2.67,95%CI:1.36,5.26)、使用导尿管(AHR = 4.62,95%CI:2.22,9.65)、使用静脉导管(AHR = 3.42,95%CI:1.22,9.61)和住院时间>20 天(AHR = 2.66,95%CI:1.43,4.94)与医院感染显著相关。

结论

研究结果表明,医院感染的发生率较低。未使用抗生素、静脉插入、机械通气、住院时间和导尿是导致医院感染的预测因素。因此,我们建议医疗机构应重视这些对医院感染有显著影响的因素,加强感染防控。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/800c/9998944/62351f598bac/fpubh-11-1087407-g0001.jpg

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