PDF(Pubmed)
Abstract：
BACKGROUND: The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS).
METHODS: This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI).
RESULTS: The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be.
CONCLUSIONS: The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.
METHODS: This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI).
RESULTS: The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be.
CONCLUSIONS: The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.
摘要：
背景：多重医院感染（MNIs）的患病率正在上升，然而,对相关风险因素的理解仍然有限，累积风险，发生的概率，以及对停留时间(LOS)的影响。
方法：这项多中心研究包括2020年至2023年7月在光明区某三甲医院的两家分院的所有住院患者，深圳。利用半马尔可夫多状态模型(MSM)分析MNI的危险因素和累积风险,预测其发生概率，并计算医院感染的额外LOS（NI）。
结果：MNI的危险因素包括年龄，入院时社区感染，手术,和联合使用抗生素。然而,MNI的累积风险低于单一医院感染（SNI）。MNI最可能发生在入院后14天内。此外,SNI平均延长LOS7.48天(95%置信区间，CI：6.06-8.68天），而MNI平均延长LOS15.94天（95%CI：14.03-18.17天）。此外，感染部位越多，额外的LOS会越长。
结论：MNI的LOS越长，治疗难度越大，患者的疾病负担越重，必须采取有针对性的预防和控制措施。
方法：这项多中心研究包括2020年至2023年7月在光明区某三甲医院的两家分院的所有住院患者，深圳。利用半马尔可夫多状态模型(MSM)分析MNI的危险因素和累积风险,预测其发生概率，并计算医院感染的额外LOS（NI）。
结果：MNI的危险因素包括年龄，入院时社区感染，手术,和联合使用抗生素。然而,MNI的累积风险低于单一医院感染（SNI）。MNI最可能发生在入院后14天内。此外,SNI平均延长LOS7.48天(95%置信区间，CI：6.06-8.68天），而MNI平均延长LOS15.94天（95%CI：14.03-18.17天）。此外，感染部位越多，额外的LOS会越长。
结论：MNI的LOS越长，治疗难度越大，患者的疾病负担越重，必须采取有针对性的预防和控制措施。
