病友暴露是医院感染的危险因素
Exposure to hospital roommates as a risk factor for health care–associated infectionAmerican Journal of Infection Control
Volume 38, Issue 3, Pages 173-181 (April 2010)
Background
Numerous patient- and hospital-level characteristics have been established as risk factors for the transmission of health care–associated infections (HAIs). Few studies have quantitatively assessed the impact of exposure to hospital roommates on the acquisition of infections. This study evaluated the association between roommate exposures and the risk of HAIs.
Methods
A retrospective cohort of adult patients admitted to a Canadian teaching hospital between June 30, 2001, and December 31, 2005, was studied. Exposures were characterized as total daily roommate exposures and daily unique roommate exposures. Outcomes examined were methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile.
Results
The number of roommate exposures per day was significantly associated with MRSA and VRE infection or colonization (MRSA: hazard ratio = 1.10, 95% confidence interval = 1.05 to 1.15; VRE: HR = 1.11, 95% CI = 1.02 to 1.21), and with C difficile infection (HR = 1.11, 95% CI = 1.03 to 1.19). A significant association also was found for number of unique roommate exposures per day and VRE (HR = 1.15, 95% CI = 1.02 to 1.28).
Conclusions
The significant associations found between daily roommate exposures and the infection outcomes suggest a possible role for limiting patient-to-patient contact in an infection prevention and control program in this facility. These findings have implications for the deployment and design of acute care hospitals. 非常新鲜的文献！
不知暴露方式是什么？ 病人间的接触，还是医务人员架起了“桥梁”？{:1_1:} The significant associations found between daily roommate exposures and the infection outcomes suggest a possible role for limiting patient-to-patient contact in an infection prevention and control program in this facility.
这里可能只研究了病人间的接触。 背景：不少研究探索了病人与医院之间在疾病传播感染风险因子的关系特点，但对病房室友之间的相互接触所引发的医院感染（卫生保健相关感染（HAIs）危险因素的定量分析不多。本研究评估了病友之间相互暴露接触与HAIs的风险关系。
方法：对在2001年1月30日和2005年12月31日期间入住加拿大某教学医院的成年患者进行回顾性研究分析。按暴露情况分为日常频繁暴露接触和每日偶尔接触。所得结果表明可（交叉）感染甲氧西林耐药金黄色葡萄球菌（MRSA），耐万古霉素肠球菌（VRE）和艰难梭菌。
结果：病友间每日频繁接触与MRSA和VRE感染或定植的风险明显相关，风险比率 = 1.10，95％的可信区间 = 1.05至1.15；VRE的风险比率HR = 1.11，95％信赖区间= 1.02〜1.21；艰难梭菌感染风险比率= 1.11，95％CI为1.03〜1.19。在每天有偶尔接触暴露的患者中也发现与感染有显著关联，VRE的风险比率= 1.15, 95% CI = 1.02 to 1.28.
结论：从病友间每日频繁的相互接触暴露出与医院感染风险显著关联来看，在（这家医院的）医院感染防控措施中，应增加限制病人接触频次的措施，这些发现同样对（急症）医院的建设和发展有指导意义。
请潮水老师指正。如果能上传这洋洋８页长的正文就更容易帮助理解了。
本帖最后由 zhenkai 于 2010-4-7 10:53 编辑
原文全文供各位老师参考谢谢 值得推广的信息。。。谢谢楼上老师们的无私奉献。。。问好各位老师。 是平时大家工作的薄弱环节，谢谢分享。 怎么总是下载失败呢？{:1_4:}
页:
[1]