P Koju, X Liu, R Zachariah, M Bhattachan, B Maharjan, S Madhup, H D Shewade, A Abrahamyan, P Shah, S Shrestha, H Li, R Shrestha
{"title":"尼泊尔侵入性设备和外科手术中与医疗保健相关的感染发生率。","authors":"P Koju, X Liu, R Zachariah, M Bhattachan, B Maharjan, S Madhup, H D Shewade, A Abrahamyan, P Shah, S Shrestha, H Li, R Shrestha","doi":"10.5588/pha.21.0039","DOIUrl":null,"url":null,"abstract":"<p><strong>Setting: </strong>Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu, Nepal.</p><p><strong>Objectives: </strong>1) To report the incidence of health-care-associated infections (HAIs), 2) to compare demographic, clinical characteristics and hospital outcomes in those with and without HAIs; and 3) to verify bacterial types in HAI and community-acquired infections (CAIs) among inpatients with invasive devices and/or surgical procedures.</p><p><strong>Design: </strong>This was a cohort study using secondary data (December 2017 to April 2018).</p><p><strong>Results: </strong>Of 1,310 inpatients, 908 (69.3%) had surgical procedures, 125 (9.5%) had invasive devices and 277 (21.1%) both. Sixty-six developed HAIs (incidence = 5/100 patient admissions, 95% CI 3.9-6.3). Individuals with HAIs had a 5.5-fold higher risk of longer hospital stays (⩾7 days) and a 6.9-fold risk of being in intensive care compared to the surgical ward. Unfavourable hospital exit outcomes were higher in those with HAIs (4.5%) than in those without (0.9%, <i>P</i> = 0.02). The most common HAI bacteria (<i>n</i> = 70) were <i>Escherichia coli</i> (44.3%), <i>Enterococcus</i> spp. (22.9%) and <i>Klebsiella</i> spp. (11.4%). Of 98 CAIs with 41 isolates, <i>E. coli</i> (36.6%), <i>Staphylococcus aureus</i> (22.0%) and methicillin-resistant <i>S. aureus</i> (14.6%) were common.</p><p><strong>Conclusion: </strong>We found relatively low incidence of HAIs, which reflects good infection prevention and control standards. This study serves as a baseline for future monitoring and action.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"32-37"},"PeriodicalIF":1.3000,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575378/pdf/","citationCount":"0","resultStr":"{\"title\":\"Incidence of healthcare-associated infections with invasive devices and surgical procedures in Nepal.\",\"authors\":\"P Koju, X Liu, R Zachariah, M Bhattachan, B Maharjan, S Madhup, H D Shewade, A Abrahamyan, P Shah, S Shrestha, H Li, R Shrestha\",\"doi\":\"10.5588/pha.21.0039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Setting: </strong>Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu, Nepal.</p><p><strong>Objectives: </strong>1) To report the incidence of health-care-associated infections (HAIs), 2) to compare demographic, clinical characteristics and hospital outcomes in those with and without HAIs; and 3) to verify bacterial types in HAI and community-acquired infections (CAIs) among inpatients with invasive devices and/or surgical procedures.</p><p><strong>Design: </strong>This was a cohort study using secondary data (December 2017 to April 2018).</p><p><strong>Results: </strong>Of 1,310 inpatients, 908 (69.3%) had surgical procedures, 125 (9.5%) had invasive devices and 277 (21.1%) both. Sixty-six developed HAIs (incidence = 5/100 patient admissions, 95% CI 3.9-6.3). Individuals with HAIs had a 5.5-fold higher risk of longer hospital stays (⩾7 days) and a 6.9-fold risk of being in intensive care compared to the surgical ward. Unfavourable hospital exit outcomes were higher in those with HAIs (4.5%) than in those without (0.9%, <i>P</i> = 0.02). The most common HAI bacteria (<i>n</i> = 70) were <i>Escherichia coli</i> (44.3%), <i>Enterococcus</i> spp. (22.9%) and <i>Klebsiella</i> spp. (11.4%). Of 98 CAIs with 41 isolates, <i>E. coli</i> (36.6%), <i>Staphylococcus aureus</i> (22.0%) and methicillin-resistant <i>S. aureus</i> (14.6%) were common.</p><p><strong>Conclusion: </strong>We found relatively low incidence of HAIs, which reflects good infection prevention and control standards. This study serves as a baseline for future monitoring and action.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":\"11 Suppl 1\",\"pages\":\"32-37\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2021-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575378/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.21.0039\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.21.0039","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
地点：尼泊尔加德满都加德满都大学医院 Dhulikhel 医院尼泊尔加德满都加德满都大学医院 Dhulikhel 医院：1）报告医疗相关感染（HAIs）的发生率；2）比较有HAIs和无HAIs患者的人口统计学、临床特征和住院结果；3）验证有侵入性设备和/或外科手术的住院患者中HAI和社区获得性感染（CAIs）的细菌类型：这是一项使用二手数据（2017 年 12 月至 2018 年 4 月）进行的队列研究：在1310名住院患者中，908人（69.3%）进行了外科手术，125人（9.5%）使用了侵入性设备，277人（21.1%）同时使用了侵入性设备和/或外科手术。其中 66 人发生了 HAI（发生率 = 5/100，95% CI 3.9-6.3）。与外科病房相比，发生 HAI 的患者住院时间延长（⩾7 天）的风险高出 5.5 倍，入住重症监护室的风险高出 6.9 倍。出现 HAI 的患者（4.5%）的出院不良后果高于未出现 HAI 的患者（0.9%，P = 0.02）。最常见的 HAI 细菌（n = 70）为大肠埃希菌（44.3%）、肠球菌属（22.9%）和克雷伯菌属（11.4%）。在 98 例 CAI 中的 41 个分离株中，大肠杆菌（36.6%）、金黄色葡萄球菌（22.0%）和耐甲氧西林金黄色葡萄球菌（14.6%）很常见：我们发现 HAIs 的发生率相对较低，这反映了良好的感染预防和控制标准。这项研究为今后的监测和行动提供了基线。
Incidence of healthcare-associated infections with invasive devices and surgical procedures in Nepal.
Setting: Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu, Nepal.
Objectives: 1) To report the incidence of health-care-associated infections (HAIs), 2) to compare demographic, clinical characteristics and hospital outcomes in those with and without HAIs; and 3) to verify bacterial types in HAI and community-acquired infections (CAIs) among inpatients with invasive devices and/or surgical procedures.
Design: This was a cohort study using secondary data (December 2017 to April 2018).
Results: Of 1,310 inpatients, 908 (69.3%) had surgical procedures, 125 (9.5%) had invasive devices and 277 (21.1%) both. Sixty-six developed HAIs (incidence = 5/100 patient admissions, 95% CI 3.9-6.3). Individuals with HAIs had a 5.5-fold higher risk of longer hospital stays (⩾7 days) and a 6.9-fold risk of being in intensive care compared to the surgical ward. Unfavourable hospital exit outcomes were higher in those with HAIs (4.5%) than in those without (0.9%, P = 0.02). The most common HAI bacteria (n = 70) were Escherichia coli (44.3%), Enterococcus spp. (22.9%) and Klebsiella spp. (11.4%). Of 98 CAIs with 41 isolates, E. coli (36.6%), Staphylococcus aureus (22.0%) and methicillin-resistant S. aureus (14.6%) were common.
Conclusion: We found relatively low incidence of HAIs, which reflects good infection prevention and control standards. This study serves as a baseline for future monitoring and action.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
