Wang Yichen, Zhang Yibo, Wang Qun, Li Wenhui, Shi Dake, Xu Yumin
Department of Hospital Infection Management, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Infect Drug Resist. 2024 Sep 28;17:4213-4221. doi: 10.2147/IDR.S481412. eCollection 2024.
Hospital-acquired infections (HAIs) caused by multidrug-resistant organisms (MDROs) pose a significant challenge to healthcare systems. The present study aimed to evaluate the impact of the infection policy to COVID-19 on the incidence of HAIs caused by MDROs.
We conducted an eight-years retrospective analysis at a hospital in Shanghai, China. Bloodstream, sputum, and urinary tract cultures of MDROs obtained 48h after admission were collected monthly from January 2016 to Dec 2023. Occupied bed days (OBDs) were used to generate monthly HAI incidences per 10,000 OBDs. The study period was divided into pre-control, in-control, and post-control cohorts, in January 2020 and January 2022. The incidence was compared using interrupted time-series regression.
In total, 6763 MDRO cultures were identified, comprising 1058 bloodstream, 4581 sputum, and 1124 urine cultures derived from 4549 patients. The incidence rates of all HAIs were 8.68 per 10,000 OBDs in the pre-control cohort, 9.76 per 10,000 OBDs in the in-control cohort and 12.58 per 10,000 OBDs in the post-control cohorts, respectively. A downward trend in the incidence of HAI was observed in the post-control cohort (p<0.05).
This study demonstrates that while the COVID-19 pandemic poses a significant challenge to infection control within hospitals, it provides a unique opportunity to enhance infection control measures and evaluate their effectiveness. In addition, these findings highlight the need for more targeted prevention and control strategies against different pathogens in future epidemics.
由多重耐药菌(MDROs)引起的医院获得性感染(HAIs)对医疗系统构成重大挑战。本研究旨在评估针对新型冠状病毒肺炎(COVID-19)的感染政策对多重耐药菌引起的医院获得性感染发病率的影响。
我们在中国上海的一家医院进行了一项为期八年的回顾性分析。从2016年1月至2023年12月,每月收集入院48小时后获得的多重耐药菌的血培养、痰培养和尿培养样本。使用占用床日(OBDs)计算每10000个占用床日的医院获得性感染月发病率。研究期分为2020年1月和2022年1月的控制前、控制中和控制后队列。使用中断时间序列回归比较发病率。
共鉴定出6763份多重耐药菌培养样本,包括来自4549例患者的1058份血培养、4581份痰培养和1124份尿培养。控制前队列中所有医院获得性感染的发病率为每10000个占用床日8.68例,控制中队列为每10000个占用床日9.76例,控制后队列为每10000个占用床日12.58例。在控制后队列中观察到医院获得性感染发病率呈下降趋势(p<0.05)。
本研究表明,虽然新型冠状病毒肺炎大流行给医院内的感染控制带来了重大挑战,但它提供了一个加强感染控制措施并评估其有效性的独特机会。此外,这些发现凸显了未来疫情中针对不同病原体采取更有针对性的预防和控制策略的必要性。