湿度对医院感染发生风险的关联分析  

Impacts of humidity on hospital acquired infection:a time-series study

作　　者：屈丹[1] 王高帅[1] 李鹏[2] QU Dan;WANG Gao-shuai;LI Peng(Department of Nosocomial Infection Management,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China;Department of Infection Control,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院感控管理科,郑州450014 [2]河南省人民医院感染管理科,郑州450003

出　　处：《医药论坛杂志》2023年第19期63-69,74,共8页Journal of Medical Forum

摘　　要：目的定量评价湿度变化对医院感染发生风险的影响。方法收集郑州大学第二附属医院2013年1月—2017年12月医院感染日报告资料及同时期郑州市气象数据,采用分布滞后非线性模型(distributed lag non-linear model,DLNM),控制温度、时间趋势、星期几效应、假期效应后分析湿度对医院感染发生风险的影响及其滞后效应。结果湿度与滞后14天内对医院感染和呼吸道部位医院感染发生的累积效应呈非线性,在湿度10%到46%区间,医院感染及呼吸道部位医院感染发生风险随湿度上升呈下降趋势,湿度为10%时两者发生风险达最大,相对危险度分别为6.194(2.195~17.481)和2.708(1.31~5.598),在46%到100%区间,两者发生风险呈倒V型,湿度为80%时两者发生风险达最大,分别为1.324(1.038~1.688)、1.223(1.04~1.437)。相对于湿度46%(25 th),干燥(26%)和潮湿(90%)均能增加医院感染和呼吸道部位医院感染发生风险,干燥效应呼吸道部位医院感染的影响更大,累积滞后效应出现在第6天,并在第14天达最大1.613(1.242~2.095)。敏感性分析显示,当改变湿度的自由度(3、4)及最大滞后天数(7、14、21、30),湿度对医院感染和呼吸道部位医院感染的效应呈现相似的模式。结论郑州地区湿度变化可能是医院感染发生风险的影响因素,干燥条件下更可能导致呼吸道部位医院感染的发生。Objective To quantify the effect of humidity change on the risk of hospital acquired infection.Methods Daily surveillance data on hospital-acquired infection of the Second Affiliated Hospital of Zhengzhou University from January 2013 to December 2017 were collected.Then,the distributed lag non-linear model(DLNM)was used to assess the influence of humidity on the risk of hospital infection and its lag effect and cumulative lag effect after controlling for temperature,time trend,day of the week effect and holiday effect.Results The cumulative relative risk of hospital acquired infectionand,noso⁃comial respiratory tract infection and humidity were nonlinearly related over 14 days.The cumulative relative risk of hospital acquired infectionand and nosocomial respiratory tract infection declined linearly with humidity at 10%to 46%with value of 6.194(2.195~17.481)and 2.708(1.31~5.598)at the peak of 10%and presented inverted V shape at 46%to 100%with value of 1.324(1.038~1.688)and 1.223(1.04~1.437)at the peak of 80%.Compared with humidity of 46%(25 th),both drying(26%)and moisture(90%)can increase the risk of hospital acquired infectionand and nosocomial respiratory tract infection.Dose-effect curve showed that the effect of drying on nosocomial respiratory tract infection was higher than hospital acquired infection.Sensitivity analysis showed that when changing the degrees of freedom(3,4)for humidity and the maxi⁃mum lag days(7,14,21,30),the effect of humidity on hospital acquired infectionand and nosocomial respiratory tract infec⁃tion showed a similar pattern.Conclusion In Zhengzhou area,humidity may be the influencing factor of the risk of hospital acquired infection.Dryness is more likely lead to the occurrence of nosocomial respiratory tract infection.

关 键 词：湿度 医院感染 呼吸道部位医院感染 分布滞后非线性模型 滞后效应 累积滞后效应 

分 类 号：R122.1[医药卫生—环境卫生学]