Associations between hospital structure, infection control and incidence of hospital-acquired viral respiratory infections: a 10-year surveillance study.

IF 4.4 2区 医学 Q1 INFECTIOUS DISEASES
Costa Salachas, Quentin Le Hingrat, Skerdi Haviari, Audrey Valdes, Vincent Mackiewicz, Isabelle Lolom, Nadhira Fidouh, Benoît Visseaux, Donia Bouzid, Diane Descamps, Jean-Christophe Lucet, Charlotte Charpentier, Solen Kernéis
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引用次数: 0

Abstract

Background: Protecting patients from hospital-acquired viral respiratory infections is a major challenge, but the hierarchy of measures to achieve this is not yet completely clear.

Aim: To describe the epidemiology of hospital-acquired viral respiratory infections and associations with structural hospital factors and adherence to infection control protocols.

Methods: Retrospective cohort study conducted over 10 consecutive years (2014-2023) within 27 hospital wards in a 900-bed university hospital in Paris, France. All hospitalized adult patients who were tested for at least one virus on a respiratory sample during their stay were included. Structural factors (percentage of double occupancy rooms) and adherence to infection control protocols by healthcare workers (measured by consumption of alcohol-based hand sanitizer and of facemasks) were included as predictors in the model.

Main outcome and measure: Incidence of hospital-acquired viral respiratory infections, defined by a positive PCR test for at least one respiratory virus, performed at least 5 days after hospital admission. Data were analyzed on ward-year aggregated data, with a linear mixed-effects model.

Findings: Overall, 183 994 viral PCR tests were performed over the study period. Incidence of hospital-acquired viral respiratory infections was 0.57/1000 hospital-days. After adjustment on other factors (mean length of stay, use of PCR testing), incidence of hospital-acquired viral respiratory infections in a given ward was significantly associated with: the incidence of community-acquired viral respiratory infections among patients admitted to the ward (+ 0.10/1000 hospital-days per each additional point of incidence; P < 0.001), the number of double-occupancy rooms (+ 0.04/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.03) and masks consumption (+ 0.33/1000 hospital-days per 10 additional masks used per day; P = 0.04). Similar results were found for double-occupancy rooms (+ 0.01/1000 hospital-days per each 10%-increase of double-occupancy rooms; P = 0.012) in the sub-group analysis of influenza cases.

Conclusion: In a given hospital ward, the incidence of community-acquired cases and the proportion of double-occupancy rooms are independently associated with the incidence hospital-acquired viral respiratory infections.

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医院结构、感染控制和医院获得性病毒性呼吸道感染发生率之间的关系:一项10年监测研究
背景:保护患者免受医院获得性病毒性呼吸道感染是一项重大挑战,但实现这一目标的措施层次尚不完全清楚。目的:描述医院获得性病毒性呼吸道感染的流行病学及其与医院结构性因素和感染控制方案依从性的关系。方法:回顾性队列研究,连续10年(2014-2023年)在法国巴黎一家拥有900个床位的大学医院的27个病房进行。所有在住院期间接受呼吸道样本至少一种病毒检测的住院成年患者都被纳入研究范围。结构因素(双人入住房间的百分比)和卫生保健工作者对感染控制方案的依从性(通过使用含酒精的洗手液和口罩来衡量)被纳入模型的预测因子。主要结局和测量指标:入院后至少5天进行至少一种呼吸道病毒PCR检测阳性的医院获得性病毒性呼吸道感染发生率。数据采用6年汇总数据进行分析,采用线性混合效应模型。结果:总体而言,在研究期间进行了183994次病毒PCR检测。医院获得性病毒性呼吸道感染发生率为0.57/1000医院日。在对其他因素(平均住院时间、PCR检测的使用)进行调整后,特定病房中医院获得性病毒性呼吸道感染的发病率与以下因素显著相关:住院患者中社区获得性病毒性呼吸道感染的发病率(每增加一个发病率点+ 0.10/1000住院日;P < 0.001),双人房的数量(每增加10%的双人房增加0.04/1000住院日;P = 0.03)和口罩使用量(每天每增加使用10个口罩,增加0.33/1000医院日;P = 0.04)。双人入住的房间也有类似的结果(每增加10%的双人入住房间,每增加0.1 /1000个住院日;P = 0.012)。结论:某医院病房内社区获得性病例发生率和双人间比例与医院获得性病毒性呼吸道感染发生率独立相关。
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来源期刊
Antimicrobial Resistance and Infection Control
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.
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