Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany.
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany; National Reference Centre for Surveillance of Nosocomial Infections, Berlin, Germany.
J Hosp Infect. 2023 Sep;139:99-105. doi: 10.1016/j.jhin.2023.05.018. Epub 2023 Jun 10.
Sinks in hospitals are a possible reservoir for healthcare-related pathogens. They have been identified as a source of nosocomial outbreaks in intensive care units (ICU); however, their role in non-outbreak settings remains unclear.
To investigate whether sinks in ICU patient rooms are associated with a higher incidence of hospital-acquired infection (HAI).
This analysis used surveillance data from the ICU component of the German nosocomial infection surveillance system (KISS) from 2017 to 2020. Between September and October 2021, all participating ICUs were surveyed about the presence of sinks in their patient rooms. The ICUs were then divided into two groups: the no-sink group (NSG) and the sink group (SG). Primary and secondary outcomes were total HAIs and HAIs associated with Pseudomonas aeruginosa (HAI-PA).
In total, 552 ICUs (NSG N=80, SG N=472) provided data about sinks, total HAIs and HAI-PA. The incidence density per 1000 patient-days of total HAIs was higher in ICUs in the SG (3.97 vs 3.2). The incidence density of HAI-PA was also higher in the SG (0.43 vs 0.34). The risk of HAIs associated with all pathogens [incidence rate ratio (IRR)=1.24, 95% confidence interval (CI) 1.03-1.50] and the risk of lower respiratory tract infections associated with P. aeruginosa (IRR=1.44, 95% CI 1.10-1.90) were higher in ICUs with sinks in patient rooms. After adjusting for confounders, sinks were found to be an independent risk factor for HAI (adjusted IRR 1.21, 95% CI 1.01-1.45).
Sinks in patient rooms are associated with a higher number of HAIs per patient-day in the ICU. This should be considered when planning new ICUs or renovating existing ones.
医院水槽可能是与医疗相关病原体的储存库。它们已被确定为重症监护病房（ICU）中医院感染爆发的源头；然而，它们在非爆发环境中的作用仍不清楚。
调查 ICU 病房中的水槽是否与更高的医院获得性感染（HAI）发生率有关。
本分析使用了 2017 年至 2020 年德国医院感染监测系统（KISS）的 ICU 部分的监测数据。2021 年 9 月至 10 月，对所有参与的 ICU 进行了水槽是否存在于其病房中的调查。然后将 ICU 分为两组：无水槽组（NSG）和水槽组（SG）。主要和次要结局是总 HAI 和铜绿假单胞菌相关 HAI（HAI-PA）。
共有 552 个 ICU（NSG N=80，SG N=472）提供了水槽、总 HAI 和 HAI-PA 的数据。SG 中每 1000 个患者日的总 HAI 发生率密度较高（3.97 比 3.2）。SG 中 HAI-PA 的发生率密度也较高（0.43 比 0.34）。所有病原体相关 HAI 的风险[发病率比（IRR）=1.24，95%置信区间（CI）1.03-1.50]和铜绿假单胞菌相关下呼吸道感染的风险[发病率比（IRR）=1.44，95%置信区间（CI）1.10-1.90]均较高。在调整混杂因素后，水槽被发现是 ICU 中 HAI 的独立危险因素（调整后的 IRR 为 1.21，95% CI 为 1.01-1.45）。
病房中的水槽与 ICU 中每个患者日的 HAI 数量增加有关。在规划新的 ICU 或翻新现有的 ICU 时，应考虑这一点。
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