Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China.
Testing Centre, Guangming District Centre for Disease Control and Prevention, Shenzhen, Guangdong, China.
Antimicrob Resist Infect Control. 2024 Jun 6;13(1):58. doi: 10.1186/s13756-024-01421-5.
The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS).
This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI).
The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be.
The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.
医院感染（NI）的发生率呈上升趋势，但目前对于其相关危险因素、累积风险、发生概率和对住院时间（LOS）的影响，仍缺乏全面的了解。
本研究为多中心研究，纳入了 2020 年 1 月至 2023 年 7 月深圳市光明区两家三级医院下属两家分院的住院患者。采用半马尔可夫多状态模型（MSM）分析多重医院感染的危险因素和累积风险，预测其发生概率，并计算医院感染的额外 LOS。
多重医院感染的危险因素包括年龄、入院时社区感染、手术和抗生素联合使用。然而，多重医院感染的累积风险低于单一医院感染。多重医院感染最有可能发生在入院后 14 天内。此外，单一医院感染平均延长 LOS7.48 天（95%CI：6.06-8.68 天），而多重医院感染平均延长 LOS15.94 天（95%CI：14.03-18.17 天）。此外，感染部位越多，额外 LOS 就越长。
多重医院感染导致 LOS 延长和治疗难度增加，给患者带来更重的疾病负担，需要采取有针对性的预防和控制措施。
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