使用电子健康记录来评估殖民压力和医院病原体获取之间的关系
Luke Sagers1, Ziming Wei1,2, Caroline McKenna2
1Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Nature communications
|February 24, 2026
概括
医院的殖民压力,患者中生物体的流行,与医院获得的感染有关. 这项研究开发了一种模拟这种压力的工具,揭示了医院中广泛传播的病原体传播.
科学领域:
- 传染性疾病 传染性疾病
- 医疗信息学 医疗信息学
- 流行病学 流行病学
背景情况:
- 住院感染 (HAI) 对住院患者构成重大风险.
- 对细菌殖民的积极监测是有效的,但资源密集且有限.
- 殖民压力,同伴患者中生物体的流行率与HAI有关,但未得到充分利用.
研究的目的:
- 开发一个开源的信息学工具来模拟殖民压力对医院收购的影响.
- 利用电子健康记录 (EHR) 数据分析殖民压力和各种病原体的获取之间的关联.
- 调查在医院内传播的生物间关系.
主要方法:
- 利用来自美国大型综合卫生系统的EHR数据 (2015年5月 - 2024年7月).
- 采用匹配的病例控制设计来评估殖民压力和医院收购.
- 模拟了对药物敏感性和耐药性病原体的殖民压力.
主要成果:
- 在所有测试的生物体中,在殖民压力和医院收购之间发现了一致的正相关性.
- 在不同的生物体之间观察到显著的积极关联 (例如,VRE和ESBL产生的K. pneumoniae).
- 在不同的生物之间 (例如,P. aeruginosa和VSE) 发现了负面关联.
结论:
- 在第三级护理环境中,即便有先进的感染控制,鼻腔传染病原体的传播也很普遍.
- 殖民压力是了解和潜在地减轻HAI的一个有价值的指标.
- 开发的软件和数据集是公开可用的,以推进研究和干预.
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