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构建和验证一个预测性风险模型的医院感染MDRO在NICU:一个多中心的观察性研究

Jinyan Zhou¹, Feixiang Luo², Jianfeng Liang³

¹Administration Department of Nosocomial Infection, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

Frontiers in medicine

|July 12, 2023

概括

这项研究开发了一种预测风险模型,以识别新生儿在新生儿重症监护室 (NICU) 患有多种耐药生物体 (MDRO) 感染的高风险. 该模型有助于制定有针对性的预防策略,以减少医院感染.

科学领域:

新生儿重症监护室 (NICU) 医学新生儿重症监护室 (NICU) 医学
传染病流行病学传染病流行病学
医疗信息学医疗信息学

背景情况:

由多药耐药生物体 (MDROs) 引起的鼻腔感染对NICU中易受伤害的新生儿构成重大威胁.
有效的预测工具对于及时干预和预防MDRO感染至关重要.

研究的目的:

构建和验证NICU中MDRO感染的预测风险模型 (PRM).
为临床工作人员提供可靠的工具,以识别高风险新生儿.
为在NICU中针对MDRO感染提供有针对性的预防和控制策略.

主要方法:

一项多中心观察性研究,涉及来自两个三级儿童医院的NICU中的新生儿.
集群采样用于将新生儿纳入建模 (2018-2020) 和验证 (2021-2022) 组.
使用单变量和二进制物流回归分析来构建PRM,并使用H-L测试,校准曲线,ROC曲线和决策曲线分析进行验证.

主要成果:

最终的PRM确定了四个独立的风险因素:低出生体重,母亲年龄≥35岁,抗生素使用>7天和MDRO殖民.
该模型在内部和外部验证后证明了良好的适配度,校准,区分和临床有效性.
构建的PRM的预测准确率为77.19%.

结论:

开发的PRM是科学上健全和可靠的工具,用于预测NICU环境中的MDRO感染.
临床工作人员可以利用PRM来早期识别高风险新生儿.
基于已识别的风险因素的有针对性的预防策略可以帮助减少NICU中MDRO感染的发生率.

关键词:

多药耐药生物多药耐药性有机体新生儿重症监护室新生儿重症监护室医院内感染的疾病.预测风险模型的预测风险模型.风险因素的风险因素是什么

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