Investigation of multiple nosocomial infections using a semi-Markov multi-state model

The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS). This multicenter study includes all hospitalized patients from...

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Bibliographic Details
Published in:Antimicrobial resistance & infection control 2024-06, Vol.13 (1), p.58-15
Main Authors: Zhong, Xiao, Wang, Dong-Li, Xiao, Li-Hua, Liu, Yan, Yang, Shan-Wen, Mo, Lan-Fang, Wu, Qin-Fei, Lin, Mei, He, Lan-Fang, Luo, Xiao-Feng
Format: Article
Language:English
Subjects:
Adult
Aged
Analysis
Anti-Bacterial Agents - therapeutic use
China - epidemiology
Cross Infection - epidemiology
Cumulative risk
Female
Health aspects
Hospital patients
Humans
Infection
Length of stay
Length of Stay - statistics & numerical data
Male
Medical research
Medicine, Experimental
Middle Aged
Multiple nosocomial infection
Nosocomial infection
Prevalence
Prevention
Risk Factors
Semi-Markov multi-state model
Tertiary Care Centers
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Summary:The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS). This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI). The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be. The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.
ISSN:2047-2994
2047-2994
DOI:10.1186/s13756-024-01421-5