Li Qianfeng, Wang Dong, Fan Hanyuan
Department of Geriatric Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, People's Republic of China.
Hospital-Acquired Infection Control department, Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, People's Republic of China.
Infect Drug Resist. 2025 May 7;18:2377-2388. doi: 10.2147/IDR.S516013. eCollection 2025.
Hospital-acquired infections (HAIs) pose significant challenges in rehabilitation hospitals, particularly affecting patients with extended stays and complex medical needs. This study analyzed HAI patterns and risk factors in a Chinese rehabilitation hospital from 2020 to 2024.
A retrospective observational study was conducted at a tertiary-care rehabilitation hospital with 25 specialized wards. Data collection included patient demographics, clinical parameters, and ward-level characteristics. Statistical analysis employed Poisson and Quasi-Poisson regression models to identify risk factors, with comprehensive diagnostic evaluation.
The study revealed an overall infection rate of 3.64%, representing 385 infections among 10,559 inpatients. The Vegetative State Awakening Department exhibited the highest infection rate at 11.1%, followed by Geriatric Rehabilitation Department (8.2%), and Neuro Rehabilitation Department wards (5.5-7.0%). Respiratory tract infections were most common (42%), with ventilator-associated pneumonia accounting for 28% of all infections. Statistical analysis identified several significant risk factors through both Poisson and Quasi-Poisson regression models. In the more reliable Quasi-Poisson model that accounted for overdispersion, tracheal intubation emerged as the strongest predictor with a coefficient of 2.02 (p < 0.001), followed by use of glucocorticoids (coefficient: 1.78, p < 0.001). While the initial Poisson model suggested a protective effect of radiation therapy, this effect was not significant in the Quasi-Poisson model.
The study highlights the critical role of tracheal intubation and glucocorticoid use in HAI development within rehabilitation settings. The significant ward-level variability in infection rates suggests the need for tailored infection control strategies. Implementation of targeted interventions focusing on these identified risk factors could help reduce HAI incidence in rehabilitation hospitals.
医院获得性感染（HAIs）给康复医院带来了重大挑战，尤其影响住院时间延长和有复杂医疗需求的患者。本研究分析了2020年至2024年中国一家康复医院的医院获得性感染模式及危险因素。
在一家拥有25个专科病房的三级康复医院进行了一项回顾性观察研究。数据收集包括患者人口统计学资料、临床参数和病房层面特征。采用泊松和拟泊松回归模型进行统计分析以识别危险因素，并进行全面的诊断评估。
该研究显示总体感染率为3.64%，在10559名住院患者中发生了385例感染。植物状态苏醒科感染率最高，为11.1%，其次是老年康复科（8.2%）和神经康复科病房（5.5 - 7.0%）。呼吸道感染最为常见（42%），呼吸机相关性肺炎占所有感染的28%。通过泊松和拟泊松回归模型进行的统计分析确定了几个显著的危险因素。在考虑了过度离散的更可靠的拟泊松模型中，气管插管是最强的预测因素，系数为2.02（p < 0.001），其次是糖皮质激素的使用（系数：1.78，p < 0.001）。虽然最初的泊松模型表明放射治疗有保护作用，但在拟泊松模型中这种作用并不显著。
该研究突出了气管插管和糖皮质激素的使用在康复环境中医院获得性感染发生中的关键作用。感染率在病房层面存在显著差异，这表明需要制定针对性的感染控制策略。针对这些已确定的危险因素实施有针对性的干预措施有助于降低康复医院中医院获得性感染的发生率。
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