Malheiro Rui, Gomes André Amaral, Fernandes Carlos, Fareleira Ana, Lebre Ana, Pascoalinho Dulce, Gonçalves-Pereira João, Paiva José-Artur, Sá-Machado Rita
EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal.
Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal.
Microorganisms. 2024 Dec 7;12(12):2522. doi: 10.3390/microorganisms12122522.
Healthcare-associated infections (HAIs) represent a major challenge in patient safety that affects services disproportionally. This paper aimed to assess how the HAI prevalence varies between hospital services and what contextual characteristics may explain such variance. A cross-sectional study was conducted on adult patients in Portuguese hospitals, using data from the European point prevalence survey of HAI prevalence. The study variables included patient, structural, and process variables, tested as risk factors, with patients clustered in hospitals. Variables with a -value ≤ 0.2 in univariate analyses were retested in a multivariable model. A total of 18,261 patients from 119 hospitals were included: 736 from 56 intensive care units (ICUs), 3160 from 72 surgical departments, and 8081 from 90 medical departments. The HAI prevalence was 7.9%, 5.9%, and 1.7%, respectively. In ICUs, only the number of devices was associated with the HAI prevalence. In surgical departments, age, comorbidities, being a specialized hospital, and a higher ratio of infection prevention and control (IPC) personnel were associated with higher SSI. The safety climate was associated with lower SSI. In medical departments, age and devices were positively associated, whereas a larger ratio of IPC nurses was negatively associated. These results may help implement targeted interventions to achieve optimal results in each department.
医疗保健相关感染（HAIs）是患者安全方面的一项重大挑战，对医疗服务造成了不均衡的影响。本文旨在评估医院各科室之间HAIs患病率的差异情况，以及哪些背景特征可以解释这种差异。利用欧洲HAIs患病率现患率调查的数据，对葡萄牙医院的成年患者进行了一项横断面研究。研究变量包括患者、结构和过程变量，作为危险因素进行测试，患者按医院进行聚类。单因素分析中P值≤0.2的变量在多变量模型中重新进行测试。共纳入了来自119家医院的18261名患者：来自56个重症监护病房（ICU）的736名患者、来自72个外科科室的3160名患者以及来自90个内科科室的8081名患者。HAIs患病率分别为7.9%、5.9%和1.7%。在ICU中，只有设备数量与HAIs患病率相关。在外科科室，年龄、合并症、专科医院性质以及更高的感染预防与控制（IPC）人员比例与手术部位感染（SSI）发生率较高相关。安全氛围与较低的SSI发生率相关。在内科科室，年龄和设备呈正相关，而IPC护士比例较高则呈负相关。这些结果可能有助于实施针对性干预措施，以便在每个科室取得最佳效果。
