Investigation of multiple nosocomial infections using a semi-Markov multi-state model.

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

Antimicrobial Resistance and Infection Control Pub Date : 2024-06-06 DOI:10.1186/s13756-024-01421-5

Xiao Zhong, Dong-Li Wang, Li-Hua Xiao, Yan Liu, Shan-Wen Yang, Lan-Fang Mo, Qin-Fei Wu, Mei Lin, Lan-Fang He, Xiao-Feng Luo

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Abstract

Background: The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS).

Method: This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI).

Results: The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be.

Conclusion: The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.

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利用半马尔可夫多状态模型调查多重医院内感染。

背景：多重医院内感染（MNIs）的发病率呈上升趋势，然而，人们对相关风险因素、累积风险、发生概率以及对住院时间（LOS）的影响的了解仍然有限：这项多中心研究包括深圳市光明区一家三甲医院的两家分院 2020 年至 2023 年 7 月期间的所有住院患者。利用半马尔可夫多状态模型（MSM）分析 MNI 的风险因素和累积风险，预测其发生概率，并计算非医院感染（NI）的额外 LOS：MNI的风险因素包括年龄、入院时的社区感染、手术和联合使用抗生素。然而，MNI 的累积风险低于单个院内感染（SNI）的累积风险。MNI 最有可能在入院后 14 天内发生。此外，SNI 会延长平均 7.48 天的生命周期（95% 置信区间：6.06-8.68 天），而 MNI 会延长平均 15.94 天的生命周期（95% 置信区间：14.03-18.17 天）。此外，感染部位越多，延长的生命周期就越长：结论：MNI 会延长患者的生命周期并增加治疗难度，从而加重患者的疾病负担，因此有必要采取有针对性的预防和控制措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

9.70

自引率

3.60%

发文量

140

审稿时长

13 weeks

期刊介绍： Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.