[目的]采用决策试用和评估实验室分析法(Decision Making And Trial Evaluation Laboratory, DEMATEL)对新冠疫情常态化防控期间医院感染风险因素进行分析。[方法]成立研究小组,采取5M1E理论和专家咨询法对文献研究获得的新冠疫情常态...[目的]采用决策试用和评估实验室分析法(Decision Making And Trial Evaluation Laboratory, DEMATEL)对新冠疫情常态化防控期间医院感染风险因素进行分析。[方法]成立研究小组,采取5M1E理论和专家咨询法对文献研究获得的新冠疫情常态化防控期间医院感染风险因素进行分析,构建风险因素的直接影响矩阵,再通过DEMATEL方法对因素间关系进行计算。[结果]研究获得医院感染风险因素27项,通过DEMATEL方法识别出12个原因因素和15个结果因素,影响因素中有8个因素的原因度和中心度均较高,对体系的影响力最大,是整个系统中的驱动要素,分别为人力配置、培训考核、感控理念、感控标准、一体防控、监督机制、绩效考核、科研教学。[结论]DEMATEL方法可作为分析新冠疫情常态化防控期间医院感染风险因素及制定改进措施的有效方法。展开更多
AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004...AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004 to 2011 were reviewed.The pre-,intra-and post-operative factors were statistically analyzed.All transplantations were approved by the ethics committee of West China Hospital,Sichuan University.Patients with definitely preoperative infections and infections within 48 h after transplantation were excluded from current study.All potential risk factors were analyzed using univariate analyses.Factors significant at a P < 0.10 in the univariate analyses were involved in the multivariate analyses.The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve.RESULTS:The serious bacterial and fungal infection rates were 14.01% and 4.35% respectively.Enterococcus faecium was the predominant bacterial pathogen,whereas Candida albicans was the most common fungal pathogen.Lung was the most common infection site for both bacterial and fungal infections.Recipient age older than 45 years,preoperative hyponatremia,intensive care unit stay longer than 9 d,postoperative bile leak and severe hyperglycemia were independent risk factors for postoperative bacterial infection.Massive red blood cells transfusion and postoperative bacterial infection may be related to postoperative fungal infection.CONCLUSION:Predictive risk factors for bacterial and fungal infections were indentified in current study.Pre-,intra-and post-operative factors can cause postoperative bacterial and fungal infections after LDLT.展开更多
The aim of this study was to analyse the responses to HIV/AIDS in BRICS （Brazil, Russia, India, China and South Africa） countries to determine if they are winning the war on this pandemic. The authors used a compara...The aim of this study was to analyse the responses to HIV/AIDS in BRICS （Brazil, Russia, India, China and South Africa） countries to determine if they are winning the war on this pandemic. The authors used a comparative case study approach and multiple data sources on HIV prevalence, incidence, mortality, and risk factors of HIV. BRICS has 42% of the world＇s population, a total of 11.1 million people living with HIV （PLHIV） and an average HIV prevalence of 2.8%. Overall, there were 11.1 million PLHIV, 739,909 new infections, and 592,786 deaths in BRICS countries in 2012. The magnitude of HIV in BRICS countries was Brazil （.5%）, Russia （1.1%）, India （.3%）, China （.1%）, and South Africa （12.2%）. New infections declined by 30% or more and overall prevalence and deaths also declined in Brazil, India, China, and South Africa. The epidemic has stabilized in Brazil at .6%. Russia has one of the world＇s fastest-growing H1V epidemics, India has the largest burden of HIV in Asia and South Africa has the largest number of PLHIV. During a 10 year period, Russia had a 47% increase in new HIV infections. This suggests that Russia may be losing the battle against HIV at this stage. On the other hand, India and South Africa seem to have turned the corner with declines in HIV infections of 43% and 38% respectively.展开更多
Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pita...Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. Methods： This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran. Centers for Disease Control and Prevention/National Healthcare Safety Network surveil- lance system criteria were applied to define 5 types of nosocomial infections. The variables analyzed as the risk factors of infection and mortality included sex, age, mechanism of injury, site of injury, injury severity score （ISS）, surgical intervention, length of hospitalization, intensive care unit （ICU） admission, and type of pathogen. Then, the incidence of nosocomial infection and also risk factors of mortality in traumatic patients were evaluated. All data analyses were performed using the statistical package for social sciences, version 15 （SPSS Inc., Chicago） and p 〈 0.05 is considered to be statistically significant. Results： The incidence of nosocomial infection was 7.2% （p 〈 0.001）. Pneumonia was the most common type of infection detected in our study. Infection led to a 7.8-fold increase in mortality of the traumatic patients （p 〈 O.001 ）. Admission in intensive care units and old age were the main risk factors of mortality in infected traumatic patients. Old age, gunshot and motor vehicle accidents, trauma to extremities and abdomen, higher injury severity score, and prolonged hospitalization, made the traumatic patients more susceptible to infection.展开更多
文摘[目的]采用决策试用和评估实验室分析法(Decision Making And Trial Evaluation Laboratory, DEMATEL)对新冠疫情常态化防控期间医院感染风险因素进行分析。[方法]成立研究小组,采取5M1E理论和专家咨询法对文献研究获得的新冠疫情常态化防控期间医院感染风险因素进行分析,构建风险因素的直接影响矩阵,再通过DEMATEL方法对因素间关系进行计算。[结果]研究获得医院感染风险因素27项,通过DEMATEL方法识别出12个原因因素和15个结果因素,影响因素中有8个因素的原因度和中心度均较高,对体系的影响力最大,是整个系统中的驱动要素,分别为人力配置、培训考核、感控理念、感控标准、一体防控、监督机制、绩效考核、科研教学。[结论]DEMATEL方法可作为分析新冠疫情常态化防控期间医院感染风险因素及制定改进措施的有效方法。
基金Supported by The National Science and Technology Major Project of China,No.2012ZX10002-016 and 2012ZX10002017-006
文摘AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004 to 2011 were reviewed.The pre-,intra-and post-operative factors were statistically analyzed.All transplantations were approved by the ethics committee of West China Hospital,Sichuan University.Patients with definitely preoperative infections and infections within 48 h after transplantation were excluded from current study.All potential risk factors were analyzed using univariate analyses.Factors significant at a P < 0.10 in the univariate analyses were involved in the multivariate analyses.The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve.RESULTS:The serious bacterial and fungal infection rates were 14.01% and 4.35% respectively.Enterococcus faecium was the predominant bacterial pathogen,whereas Candida albicans was the most common fungal pathogen.Lung was the most common infection site for both bacterial and fungal infections.Recipient age older than 45 years,preoperative hyponatremia,intensive care unit stay longer than 9 d,postoperative bile leak and severe hyperglycemia were independent risk factors for postoperative bacterial infection.Massive red blood cells transfusion and postoperative bacterial infection may be related to postoperative fungal infection.CONCLUSION:Predictive risk factors for bacterial and fungal infections were indentified in current study.Pre-,intra-and post-operative factors can cause postoperative bacterial and fungal infections after LDLT.
文摘The aim of this study was to analyse the responses to HIV/AIDS in BRICS （Brazil, Russia, India, China and South Africa） countries to determine if they are winning the war on this pandemic. The authors used a comparative case study approach and multiple data sources on HIV prevalence, incidence, mortality, and risk factors of HIV. BRICS has 42% of the world＇s population, a total of 11.1 million people living with HIV （PLHIV） and an average HIV prevalence of 2.8%. Overall, there were 11.1 million PLHIV, 739,909 new infections, and 592,786 deaths in BRICS countries in 2012. The magnitude of HIV in BRICS countries was Brazil （.5%）, Russia （1.1%）, India （.3%）, China （.1%）, and South Africa （12.2%）. New infections declined by 30% or more and overall prevalence and deaths also declined in Brazil, India, China, and South Africa. The epidemic has stabilized in Brazil at .6%. Russia has one of the world＇s fastest-growing H1V epidemics, India has the largest burden of HIV in Asia and South Africa has the largest number of PLHIV. During a 10 year period, Russia had a 47% increase in new HIV infections. This suggests that Russia may be losing the battle against HIV at this stage. On the other hand, India and South Africa seem to have turned the corner with declines in HIV infections of 43% and 38% respectively.
文摘Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. Methods： This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran. Centers for Disease Control and Prevention/National Healthcare Safety Network surveil- lance system criteria were applied to define 5 types of nosocomial infections. The variables analyzed as the risk factors of infection and mortality included sex, age, mechanism of injury, site of injury, injury severity score （ISS）, surgical intervention, length of hospitalization, intensive care unit （ICU） admission, and type of pathogen. Then, the incidence of nosocomial infection and also risk factors of mortality in traumatic patients were evaluated. All data analyses were performed using the statistical package for social sciences, version 15 （SPSS Inc., Chicago） and p 〈 0.05 is considered to be statistically significant. Results： The incidence of nosocomial infection was 7.2% （p 〈 0.001）. Pneumonia was the most common type of infection detected in our study. Infection led to a 7.8-fold increase in mortality of the traumatic patients （p 〈 O.001 ）. Admission in intensive care units and old age were the main risk factors of mortality in infected traumatic patients. Old age, gunshot and motor vehicle accidents, trauma to extremities and abdomen, higher injury severity score, and prolonged hospitalization, made the traumatic patients more susceptible to infection.
