中国感染控制杂志2025，Vol.24Issue(5)：657-665,9.DOI:10.12138/j.issn.1671-9638.20255438
2012-2023年基于Joinpoint回归模型的ICU医院感染变化趋势分析
Trend changes of healthcare-associated infection in intensive care unit:an analysis based on Joinpoint regression model from 2012 to 2023
摘要
Abstract
Objective To analyze the monitoring of healthcare-associated infection(HAI)in the intensive care unit(ICU)over the past 12 years based on Joinpoint regression model,and evaluate the trend changes and relevant fac-tors of HAI incidence.Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring.Trend changes of HAI incidence and the correlation with con-sumption of hand hygiene products as well as HAI management measures were analyzed.Results From 2012 to 2023,6 929 ICU patients were included in the monitoring,543 patients had 655 episodes of HAI,with incidence and case incidence of HAI being 7.84％ and 9.45％,respectively.The average severity of the disease was 3.62,and the adjusted HAI incidence was 2.17％.The daily incidence of ventilator-associated pneumonia(VAP),cathe-ter-associated urinary tract infection(CAUTI),and central line-associated bloodstream infection(CLABSI)were 6.19‰,3.45‰,and 1.23‰,respectively.The consumption of hand hygiene products was 122.98 mL/bed-day.The compliance rate and correct rate of hand hygiene were 90.63％and 90.46％,respectively.From 2012 to 2023,incidence of HAI(51.29％vs 4.39％),case incidence of HAI(72.41％vs 4.94％),the adjusted incidence of HAI(15.98％vs 1.04％),daily incidence of VAP(22.50‰ vs 4.33‰),daily incidence of CAUTI(14.23‰ vs 1.64‰),and daily incidence of CLABSI(10.60‰ vs 0.20‰)all decreased significantly(all P＜0.05).Both con-sumption of hand hygiene products(75.16 mL/bed-day vs 147.35 mL/bed-day)and correct rate of hand hygiene(85.00％vs 90.28％)increased significantly(both P＜0.05).A total of 1 946 pathogens were detected,with an increase in the proportion of Staphylococcus aureus(1.30％ vs 9.57％)and a decrease in the proportion of fungi(11.04％vs 1.74％).The daily consumption of hand hygiene products negatively correlated with the incidence of HAI,the case incidence of HAI,as well as the daily incidence of CAUTI and CLABSI(all P＜0.05).Incorpora-ting HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence(P＜0.05).Conclusion HAI-related incidence presents a downward trend.Scientific and comprehen-sive HAI prevention and control management measures such as healthcare workers'hand hygiene management,on-line HAI real-time monitoring system,and incorporating HAI management into performance assessment can de-crease HAI-related incidence and promote the improvement of medical quality.关键词
医院感染/感染预防与控制/手卫生/重症监护病房/呼吸机相关肺炎/导尿管相关尿路感染/中央导管相关血流感染/Joinpoint回归Key words
healthcare-associated infection/infection prevention and control/hand hygiene/intensive care unit/ventilator-associated pneumonia/catheter-associated urinary tract infection/central line-associated-bloodstream infection/Joinpoint regression分类
医药卫生引用本文复制引用
陈音汁,涂载澜,周明川,叶和梅,钟贞,成燕,刘小艳,侯章梅..2012-2023年基于Joinpoint回归模型的ICU医院感染变化趋势分析[J].中国感染控制杂志,2025,24(5):657-665,9.基金项目
2023年中国社会福利基金会护爱基金(HLCXKT-20230503) （HLCXKT-20230503）
2023年重庆市人民医院医院医学科研创新基金(Y2023GLYJXM02) （Y2023GLYJXM02）
