Aloufi Malak, Aloufi Mohammed E, Almalki Shrouq R, Hassanien Noha Saleh M
Preventive Medicine, Health Cluster, Taif, SAU.
Public Health, Health Cluster, Taif, SAU.
Cureus. 2024 Sep 14;16(9):e69423. doi: 10.7759/cureus.69423. eCollection 2024 Sep.
Healthcare-associated infections (HAIs) represent a significant challenge in hospital settings, contributing to increased morbidity, mortality, and healthcare costs. This study aimed to estimate the prevalence and socio-demographic and clinical determinants of HAIs at the King Abdulaziz Specialized Hospital (KAASH) in Taif, Saudi Arabia.
A hospital-based cross-sectional study was conducted from March 2023 to January 2024 targeting inpatients aged 18 and above in all units and wards. Data were collected using the National Healthcare Safety Network (NHSN) criteria for definitions of surveillance. A structured questionnaire gathered socio-demographic and clinical data from patients or next of kin if the patient was not fully oriented. Descriptive statistics were performed, and analytical methods used included Pearson chi-square test, Pearson correlation, independent t-test, and one-way analysis of variance.
Among 318 participants included in this study, the mean age of participants was 56.44 years, with a slight female predominance (n=164, 51.6%). Hypertension (n=162, 50.9%) and diabetes (n=126, 39.6%) were the most prevalent comorbidities. Pneumonia (n=60, 26.8%) and trauma (n=55, 17.4%) were the leading causes of admission. The two most common HAIs included catheter-associated urinary tract infections (CAUTI) (n=124, 39%) and central line-associated bloodstream infections (CLABSI) (n=74, 23.3%). The primary causative organisms were (n=96, 30.2%) and (n=32, 10.1%). The most significant predictors of HAIs were as follows: For CLABSI, risk factors include having three or more comorbidities, fever above 37.8°C, chills or rigors, hypotension, and positive blood culture. For CAUTI, key predictors were urinary tract infection (UTI), positive urine culture, acute pain or swelling of the testes, suprapubic tenderness, visible hematuria, and leukocytosis. Significant predictors of bloodstream infections (BSI) include having a BSI, positive blood culture, chills or rigors, and hypotension. Fever and hypotension increased CLABSI and BSI risk but reduced the CAUTI risk.
The study highlights a significant burden of HAIs at the KAASH, with multiple predictors. The findings underscore the need for robust infection control measures and targeted interventions to reduce HAI incidence and improve patient outcomes.
医疗保健相关感染（HAIs）是医院环境中的一项重大挑战，会导致发病率、死亡率上升以及医疗成本增加。本研究旨在估计沙特阿拉伯塔伊夫市阿卜杜勒阿齐兹专科医院（KAASH）的HAIs患病率及其社会人口统计学和临床决定因素。
于2023年3月至2024年1月开展了一项基于医院的横断面研究，目标是所有科室和病房中18岁及以上的住院患者。使用国家医疗安全网络（NHSN）的监测定义标准收集数据。若患者意识不完全清醒，则通过结构化问卷从患者或其近亲处收集社会人口统计学和临床数据。进行了描述性统计，使用的分析方法包括Pearson卡方检验、Pearson相关性分析、独立t检验和单因素方差分析。
本研究纳入的318名参与者中，参与者的平均年龄为56.44岁，女性略占多数（n = 164，51.6%）。高血压（n = 162，50.9%）和糖尿病（n = 126，39.6%）是最常见的合并症。肺炎（n = 60，26.8%）和创伤（n = 55，17.4%）是主要的入院原因。两种最常见的HAIs包括导管相关尿路感染（CAUTI）（n = 124，39%）和中心静脉导管相关血流感染（CLABSI）（n = 74，23.3%）。主要致病菌为（n = 96，30.2%）和（n = 32，10.1%）。HAIs的最重要预测因素如下：对于CLABSI，危险因素包括有三种或更多合并症、体温高于37.8°C、寒战或发冷、低血压以及血培养阳性。对于CAUTI，关键预测因素是尿路感染（UTI）、尿培养阳性、睾丸急性疼痛或肿胀、耻骨上压痛、肉眼血尿和白细胞增多。血流感染（BSI）的重要预测因素包括患有BSI、血培养阳性、寒战或发冷以及低血压。发热和低血压会增加CLABSI和BSI风险，但会降低CAUTI风险。
该研究突出了KAASH医院HAIs的重大负担以及多种预测因素。研究结果强调需要采取强有力的感染控制措施和针对性干预措施，以降低HAIs发病率并改善患者预后。
