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环境卫生与医院感染的时间序列研究:基于广义相加模型(GAM)

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目的 定量分析环境卫生对医院感染发生的影响。方法 收集某三甲医院2018年1月-2022年12月医院感染与环境卫生学监测资料,采用时间序列的广义相加模型分析环境检出菌落形成单位(CFU)对医院感染发生的影响。结果 单污染模型显示,医院感染与工作人员手细菌菌落数之间存在显著正相关性(β1=0。009,P=0。012),工作人员手月度平均菌落形成单位(MCFU/Dish)每升高1个四分位数间距(IQR),医院感染发生率增加13。28%(95%CI:2。82%~24。81%);亚组分析与滞后效应分析显示,工作人员手月度MCFU/Dish(卫生手消毒后)升高1个IQR,当月(lag0)医院感染超额风险(ER)为16。26%(95%CI:15。45%~17。09%)。多污染模型中,物体表面污染与医院感染的相关性同样具有统计学意义。结论 医院环境卫生与医院感染之间存在显著相关性。
Environmental hygiene and healthcare-associated infection:a time-series study based on generalized additive model
Objective To quantitatively analyze the impact of environmental hygiene on the occurrence of health-care-associated infections(HAI).Methods Monitoring data of HAI and environmental hygiene from a tertiary first-class hospital from January 2018 to December 2022 were collected,and the impact of environmental bacterial colony forming unit(CFU)on the occurrence of HAI was analyzed by a time-series generalized additive model.Results The single-contamination model showed a significant positive correlation between HAI and staff's hand bacterial CFU(β1=0.009,P=0.012).For an increase of 1 interquartile range(IQR)in the monthly mean CFU per dish(MCFU/Dish)of staffs'hand,the incidence of HAI increased by 13.28%(95%CI:2.82%-24.81%).Subgroup and lag effect analysis showed that when the monthly MCFU/Dish(after hand disinfection)of staffs'hand in-creased by one IQR,the excess risk(ER)of HAI for the month(lag0)was 16.26%(95%CI:15.45%-17.09%).In the multi-contamination model,the correlation between surface contamination and HAI was also statistically sig-nificant.Conclusion There is a significant correlation between hospital environmental hygiene and the occurrence of HAI.

healthcare-associated infectiontime-series analysisgeneralized additive modelenvironmental hy-gienehand hygiene

林凯、陈坤、王建炳、范芳华、梁辉、陈芳、金凯玲、储文杰、陈伟国、单欢

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浙江大学公共卫生学院,浙江杭州 310058

浙江医院医院感染管理科,浙江杭州 310058

浙江医院微生物实验室,浙江杭州 310058

浙江省疾病预防控制中心免疫规划所,浙江杭州 310052

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医院感染 时间序列分析 广义相加模型 环境卫生 手卫生

浙江省医药卫生科技计划项目

2021KY625

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(7)