医院感染暴发预警的方法研究

Analysis on method for early warning of hospital-acquired infection outbreak

目的探索一种通过挖掘临床微生物数据早期预警医院感染暴发的方法,使感染控制工作更有目的有重点地开展,提高工作效率。方法采用移动百分位数法,以某种病原菌一周累计检出数的P95作为预警阈值(若P95<3则以3作为阈值)。若累计检出数超过阈值则产生预警信号,SAS程序自动绘制时序图,再人工对时序图进行甄别,然后对相关病历进行回顾性调查,判断是否属于暴发。结果基于某医院2013年微生物数据,通过本方法共产生126个预警信号,经过图形甄别筛选出8次疑似暴发信号,回顾性调查确认其中5次属于暴发。结论本方法具有简单、高效、成本低等特点,是一种预警院感暴发的有效工具。

OBJECTIVE To explore a new method for the early warning of hospital-acquired infection outbreak by mining the clinical microbial data, so as to make it more focused on the work, and improve the work efficiency. METHODS Using the mobile percentile method, P95 of the cumulative detection frequency of a certain pathogenic bacteria in one week was served as an early warning threshold （if the P95 was less than 3, then 3 was defined as the threshold）. If the cumulative frequency exceeded the threshold, a warning signal would be generated and the timing sequence diagram would be drawn by the SAS program automatically. After screening the timing diagram artificially and reviewing the relevant medical records, the warning could be determined whether it was a suspected hospital--acquired infection outbreak. RESULTS Based on the microbiological data of a hospital in 2013, 126 warning signals were generated by the method and 8 suspected outbreak signals were screened out. Retrospective investigation confirmed that 5 of them were suspected outbreaks. CONCLUSION This method is simple, efficient and with low cost, which can be an effective tool for the early warning of hospital-acquired infection outbreaks.