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在SHEA的官方杂志,ICHE,
最新发表了一篇文章,研究者采用多因素模型,分析患者房间大小与医院内CDI风险关系
研究显示,房间越大,CDI感染风险增加,每增加50英尺,感染增加3倍。之前四代头孢暴露(如头孢吡肟)、恶性肿瘤以及免疫抑制剂使用也是危险因素。
房间面积与感染风险关系,可能原因是房间越大,需要消毒的面积就越大,造成消毒失败的可能性也越大。
Environmental Transmission of Clostridium difficile: Association Between Hospital Room Size and C. difficileInfection.
AbstractOBJECTIVE To evaluate the association between hospital room square footage and acquisition of nosocomial Clostridium difficile infection (CDI). METHODS A case-control study was conducted at a university hospital during the calendar year of 2011. Case patients were adult inpatients withnosocomial CDI. Control patients were hospitalized patients without CDI and were randomly selected and matched to cases in a 2:1 ratio on the basis of hospital length of stay in 3-day strata. A multivariate model was developed using conditional logistic regression to evaluate risk factors fornosocomial CDI. RESULTS A total of 75 case patients and 150 control patients were included. On multivariate analyses, greater square footage of the hospital room was associated with a significantly increased risk of acquiring CDI (odds ratio for every 50 ft2 increase, 3.00; 95% CI, 1.75-5.16; P<.001). Other factors associated with an increased risk of CDI were location in a single room (odds ratio, 3.43; 95% CI, 1.31-9.05; P=.01), malignanttumor (4.56; 1.82-11.4; P=.001), and receipt of cefepime (2.48; 1.06-5.82; P=.04) or immunosuppressants (6.90; 2.07-23.0; P=.002) within the previous 30 days. CONCLUSIONS Greater room square footage increased the risk of acquisition of CDI in the hospital setting, likely owing to increased environmental contamination and/or difficulty in effective disinfection. Future studies are needed to determine feasible and effective cleaning protocols based on patient and room characteristics. Infect Control Hosp Epidemiol 2015;00(0): 1-5.
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