Chongqing Public Health Medical Center, Chongqing, China.
Front Public Health. 2024 Oct 17;12:1417645. doi: 10.3389/fpubh.2024.1417645. eCollection 2024.
This study aimed to investigate the prevalence of hospital-acquired infections (HAIs) and their main influencing factors in a specialized infectious disease hospital in Chongqing from 2017 to 2023, providing reference for the formulation of precise infection control measures.
A retrospective cross-sectional survey method was employed, combining bedside investigations with medical record reviews. Surveys were conducted on all hospitalized patients on a certain day of the last week of October each year from 2017 to 2023. Data collected included patients' basic information, diagnosis, and hospital infection status. Statistical analysis, including retrospective case-control and multivariable logistic regression analysis, was performed to identify the risk factors for hospital infections.
The investigation compliance rate for the prevalence of HAIs in the specialized infectious disease hospital in Chongqing from 2017 to 2023 was greater than 96% each year. The prevalence rate of HAIs ranged from 0.89 to 2.52%. Hospital infection departments were mainly concentrated in general internal medicine, tuberculosis, and HIV/AIDS departments, accounting for 31.25, 26.25, and 23.75%, respectively. The most common infection site was the lower respiratory tract (54.22%), followed by bloodstream and urinary tract infections, each accounting for 9.64%. The predominant pathogens of hospital infections were and fungi. The utilization rate of antimicrobial drugs ranged from 20.75 to 33.25%, primarily for monotherapy. The rate of pathogen testing for therapeutic antimicrobial drug use was 82.84%, meeting national requirements. Multivariable logistic regression analysis revealed that the use of antibiotic (OR = 7.46, 95%CI 2.54-21.89, < 0.001) and the presence of cardiovascular diseases (OR = 26.69, 95%CI 6.69-106.54, < 0.001) increased the risk of HAIs.
The prevalence of HAIs in specialized infectious disease hospitals remains stable, primarily concentrated in departments such as general internal medicine, tuberculosis, and HIV/AIDS. The lower respiratory tract is the main infection site, and comorbid cardiovascular diseases and antibiotic use are risk factors for HAIs. Therefore, to reduce the risk of hospital infections, it is necessary to strengthen the daily monitoring of key departments and the care of key patients. Further implementation of precise and effective infection control measures, including rational antibiotic use, regular infection monitoring and pathogen culture is warranted.
本研究旨在调查 2017 年至 2023 年期间重庆某传染病专科医院的医院获得性感染(HAI)患病率及其主要影响因素,为制定精准的感染控制措施提供参考。
采用回顾性横断面调查方法,结合床边调查和病历回顾。每年 10 月最后一周的某一天对所有住院患者进行调查。收集的资料包括患者的基本信息、诊断和医院感染情况。采用回顾性病例对照和多变量 logistic 回归分析,识别医院感染的危险因素。
2017 年至 2023 年重庆某传染病专科医院 HAI 患病率调查的依从率每年均大于 96%。HAI 患病率为 0.89%2.52%。医院感染科室主要集中在普通内科、结核病和 HIV/AIDS 科室,分别占 31.25%、26.25%和 23.75%。最常见的感染部位是下呼吸道(54.22%),其次是血流感染和尿路感染,各占 9.64%。医院感染的主要病原体为细菌和真菌。抗菌药物使用率为 20.75%33.25%,主要为单药治疗。治疗性抗菌药物应用的病原体检测率为 82.84%,符合国家要求。多变量 logistic 回归分析显示,使用抗生素(OR=7.46,95%CI 2.54-21.89, < 0.001)和存在心血管疾病(OR=26.69,95%CI 6.69-106.54, < 0.001)增加了 HAI 的风险。
传染病专科医院 HAI 患病率保持稳定,主要集中在普通内科、结核病和 HIV/AIDS 等科室。下呼吸道是主要的感染部位,合并心血管疾病和使用抗生素是 HAI 的危险因素。因此,为降低医院感染风险,需要加强对重点科室和重点患者的日常监测。进一步实施精准有效的感染控制措施,包括合理使用抗生素、定期感染监测和病原体培养。