Araştırma Makalesi
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Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?

Yıl 2022, Cilt: 20 Sayı: 2, 177 - 185, 05.08.2022
https://doi.org/10.20518/tjph.989565

Öz

Objective: Standardized infection ratio (SIR) for ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) has been calculated using formulas obtained from the national models in Turkey since 2016. we aimed to evaluate the current usability of the national models by using 2020 data and whether the models need to be updated. Methods: The database used for The National HAI Surveillance Network Summary Report 2020 was used for remodelling. For each type of infection, remodeling was performed with 2020 data using the variables in the national models. The number of CLABSIs, CAUTIs and VAPs was the dependent variable for each negative binomial model with a logarithmic link function. Incidence rate ratios (IRRs) from the repeated models were compared with the national models using 95% confidence intervals. Results: In each model, all variables in the national models were again statistically significant (ps<0.05). Although the IRRs were similar for most of the risk factors, the size of the risk for some of them changed significantly between the national models and our models. In the national VAP and CAUTI model, the reference category for hospital type was private hospitals, while in our models, it was state hospitals. In addition, the IRRs for CAUTI in state hospitals, training and research hospitals and university hospitals were significantly lower than in the national model. Conclusion: It is necessary to update the coefficients used in the calculation of the predicted infection numbers in the SIR formulas, especially for VAP and CAUTI.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

The authors thank to all infection control nurses and physicians in all hospitals in Turkey for providing these data.

Kaynakça

  • Infection Control Regulation of Inpatient Treatment Institutions. Official Gazette (Issue: 25903). (In Turkish).
  • Turkish General Directorate of Public Health. The national healthcare-associated infections surveillance standards 2017. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Klavuzlar/Ulusal_Saglik_Hizmeti_Iliskili_Enfeksiyonlar_Surveyans_Standartlari_2017.pdf
  • Turkish General Directorate of Public Health. The national healthcare-associated infections surveillance guideline 2017. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Klavuzlar/Ulusal_Saglik_Hizmeti_Iliskili_Enfeksiyonlar_Surveyans_Rehber Versiyon_1.pdf
  • Hekimoglu CH , Alp Mese E . The adjusted standardized infection ratio and cumulative attributable difference for central line-associated bloodstream infections and catheter-associated urinary tract infections in 2017, in Turkey. J Immunol Clin Microbiol 2020;5(1): 41-49.
  • Gozel MG, Hekimoglu CH, Gozel EY, Batir E, McLaws ML, Alp Mese E. National Infection Control Program in Turkey: The healthcare associated infection rate experiences over 10 years. Am J Infect Control 2021;49(7):885-892.
  • Refik Saydam Hygiene Center Presidency. The national nosocomial infections surveillance network (UHESA) report, Summary data, 2008-2009. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/UHESA_Ozet_Raporu_2008_-_2009.pdf
  • Turkish General Directorate of Public Health. The summary report of standardized infection ratio and cumulative attributable difference for invasive device-associated infections in intensive care units in Turkey, 2016. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/Standardize_Enfeksiyon_Orani_SIR_ve_Kumulatif_Atfedilebilir_Fark_CAD_Raporu_2016.pdf
  • Turkish General Directorate of Public Health. The summary report of standardized utilization ratio in intensive care units in Turkey, 2017. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/Standardize_Arac_Kullanim_Orani_SAKO_Raporu_2017.pdf
  • Hacimustafaoglu M. Standardized infection ratio (SIR). J Pediatr Inf 2019;13(2):121-123. (In Turkish)
  • Kaya Kalem A, Guner R, Kayaaslan B, Hasanoğlu I. Invasive Device-related Infections and Standardized Infection Ratios in an Training and Research Hospital Intensive Care Units. Flora 2020; 25(2):228-235. (In Turkish)
  • Sonmez A, Ozturk S, Abacigil F. Health Care Related Infection Epidemiology and Surveillance. Journal of Nursing Science. 2021;4(1):41-45. (In Turkish)
  • Centres for Disease Control and Prevention. The NHSN Standardized Infection Ratio (SIR): A Guide to the SIR. Available at: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf
  • Centers for Disease Control and Prevention. Your guide to the standardized infection ratio (SIR). NHSN e-news: SIRs Special Edition. 2010:1-14.
  • Rioux C, Grandbastien B, Astagneau P. The standardized incidence ratio as a reliable tool for surgical site infection surveillance. Infect Control Hosp Epidemiol 2006;27:817-824.

Standardize enfeksiyon oranı: Türkiye’de yoğun bakım ünitelerinde ulusal invaziv araç ilişkili enfeksiyon modellerini hala güvenilir bir şekilde kullanabilir miyiz?

Yıl 2022, Cilt: 20 Sayı: 2, 177 - 185, 05.08.2022
https://doi.org/10.20518/tjph.989565

Öz

Amaç: Ventilatör ilişkili pnömoni (VİP), santral kateter ilişkili kan dolaşımı enfeksiyonu (SKİ-KDE) ve kateter ilişkili idrar yolu enfeksiyonu (Kİ-İYE) için standardize enfeksiyon oranı (SIR) 2016 yılından itibaren Türkiye’de ulusal modellerden elde edilen formüller kullanılarak hesaplanmaktadır. Bu çalışmada 2020 yılı verileri kullanılarak ulusal modellerin mevcut kullanılabilirliği ve modellerin güncellenmesinin gerekli olup olmadığının değerlendirilmesi amaçlanmıştır. Yöntem: Ulusal Sağlık Hizmeti İlişkili Enfeksiyonlar Sürveyans Ağı Özet Raporu 2020 için kullanılan veri tabanı yeniden modelleme için kullanılmıştır. Her enfeksiyon türü için ulusal modellerdeki değişkenler kullanılarak 2020 verileriyle yeniden modelleme yapılmıştır. SKİ-KDE, Kİ-İYE ve VİP sayısı, logaritmik bağlantı fonksiyonuna sahip negatif binomial modeller için bağımlı değişkendi. Tekrarlanan modellerden elde edilen insidans oranı oranları (IRR’ler), %95 güven aralıkları kullanılarak mevcut ulusal modellerle karşılaştırıldı. Bulgular: Her bir modelde, ulusal modellerdeki tüm değişkenler istatistiksel olarak anlamlıydı (p<0,05). Risk faktörlerinin çoğu için IRR’ler benzer olmasına rağmen, bazılarının risk boyutu ulusal modeller ve çalışmadaki modeller arasında önemli ölçüde değişmiştir. Ulusal VİP ve Kİ-İYE modelinde hastane türü değişkeninin referans kategorisi özel hastaneler iken bu çalışmadaki modellerde referans kategorisi devlet hastaneleridir. Ayrıca devlet hastanelerinde, eğitim ve araştırma hastanelerinde ve üniversite hastanelerinde Kİ-İYE için IRR’ler ulusal modelden önemli ölçüde düşüktü. Sonuç: Özellikle VİP ve Kİ-İYE için SIR formüllerinde öngörülen enfeksiyon sayılarının hesaplanmasında kullanılan katsayıların güncellenmesi gerekmektedir.

Proje Numarası

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Kaynakça

  • Infection Control Regulation of Inpatient Treatment Institutions. Official Gazette (Issue: 25903). (In Turkish).
  • Turkish General Directorate of Public Health. The national healthcare-associated infections surveillance standards 2017. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Klavuzlar/Ulusal_Saglik_Hizmeti_Iliskili_Enfeksiyonlar_Surveyans_Standartlari_2017.pdf
  • Turkish General Directorate of Public Health. The national healthcare-associated infections surveillance guideline 2017. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Klavuzlar/Ulusal_Saglik_Hizmeti_Iliskili_Enfeksiyonlar_Surveyans_Rehber Versiyon_1.pdf
  • Hekimoglu CH , Alp Mese E . The adjusted standardized infection ratio and cumulative attributable difference for central line-associated bloodstream infections and catheter-associated urinary tract infections in 2017, in Turkey. J Immunol Clin Microbiol 2020;5(1): 41-49.
  • Gozel MG, Hekimoglu CH, Gozel EY, Batir E, McLaws ML, Alp Mese E. National Infection Control Program in Turkey: The healthcare associated infection rate experiences over 10 years. Am J Infect Control 2021;49(7):885-892.
  • Refik Saydam Hygiene Center Presidency. The national nosocomial infections surveillance network (UHESA) report, Summary data, 2008-2009. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/UHESA_Ozet_Raporu_2008_-_2009.pdf
  • Turkish General Directorate of Public Health. The summary report of standardized infection ratio and cumulative attributable difference for invasive device-associated infections in intensive care units in Turkey, 2016. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/Standardize_Enfeksiyon_Orani_SIR_ve_Kumulatif_Atfedilebilir_Fark_CAD_Raporu_2016.pdf
  • Turkish General Directorate of Public Health. The summary report of standardized utilization ratio in intensive care units in Turkey, 2017. (In Turkish) Available at: https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/Standardize_Arac_Kullanim_Orani_SAKO_Raporu_2017.pdf
  • Hacimustafaoglu M. Standardized infection ratio (SIR). J Pediatr Inf 2019;13(2):121-123. (In Turkish)
  • Kaya Kalem A, Guner R, Kayaaslan B, Hasanoğlu I. Invasive Device-related Infections and Standardized Infection Ratios in an Training and Research Hospital Intensive Care Units. Flora 2020; 25(2):228-235. (In Turkish)
  • Sonmez A, Ozturk S, Abacigil F. Health Care Related Infection Epidemiology and Surveillance. Journal of Nursing Science. 2021;4(1):41-45. (In Turkish)
  • Centres for Disease Control and Prevention. The NHSN Standardized Infection Ratio (SIR): A Guide to the SIR. Available at: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf
  • Centers for Disease Control and Prevention. Your guide to the standardized infection ratio (SIR). NHSN e-news: SIRs Special Edition. 2010:1-14.
  • Rioux C, Grandbastien B, Astagneau P. The standardized incidence ratio as a reliable tool for surgical site infection surveillance. Infect Control Hosp Epidemiol 2006;27:817-824.
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Can Hüseyin Hekimoğlu 0000-0002-2156-4636

Selda Sahan Bu kişi benim 0000-0001-9413-8155

Esen Batır Bu kişi benim 0000-0002-9341-2658

Emine Yıldırım Gozel Bu kişi benim 0000-0002-1383-5264

Dilek Altun Bu kişi benim 0000-0002-0602-9467

Gulen Pehlıvanturk Bu kişi benim 0000-0002-2812-2216

Muhammet Comce Bu kişi benim 0000-0002-4536-5295

Fatih Kara Bu kişi benim 0000-0002-7267-7809

Proje Numarası -
Yayımlanma Tarihi 5 Ağustos 2022
Gönderilme Tarihi 3 Eylül 2021
Kabul Tarihi 14 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 20 Sayı: 2

Kaynak Göster

APA Hekimoğlu, C. H., Sahan, S., Batır, E., Yıldırım Gozel, E., vd. (2022). Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?. Turkish Journal of Public Health, 20(2), 177-185. https://doi.org/10.20518/tjph.989565
AMA Hekimoğlu CH, Sahan S, Batır E, Yıldırım Gozel E, Altun D, Pehlıvanturk G, Comce M, Kara F. Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?. TJPH. Ağustos 2022;20(2):177-185. doi:10.20518/tjph.989565
Chicago Hekimoğlu, Can Hüseyin, Selda Sahan, Esen Batır, Emine Yıldırım Gozel, Dilek Altun, Gulen Pehlıvanturk, Muhammet Comce, ve Fatih Kara. “Standardized Infection Ratio: Can We Still Reliably Use the National Invasive Device- Associated Infection Models in Intensive Care Units in Turkey?”. Turkish Journal of Public Health 20, sy. 2 (Ağustos 2022): 177-85. https://doi.org/10.20518/tjph.989565.
EndNote Hekimoğlu CH, Sahan S, Batır E, Yıldırım Gozel E, Altun D, Pehlıvanturk G, Comce M, Kara F (01 Ağustos 2022) Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?. Turkish Journal of Public Health 20 2 177–185.
IEEE C. H. Hekimoğlu, “Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?”, TJPH, c. 20, sy. 2, ss. 177–185, 2022, doi: 10.20518/tjph.989565.
ISNAD Hekimoğlu, Can Hüseyin vd. “Standardized Infection Ratio: Can We Still Reliably Use the National Invasive Device- Associated Infection Models in Intensive Care Units in Turkey?”. Turkish Journal of Public Health 20/2 (Ağustos 2022), 177-185. https://doi.org/10.20518/tjph.989565.
JAMA Hekimoğlu CH, Sahan S, Batır E, Yıldırım Gozel E, Altun D, Pehlıvanturk G, Comce M, Kara F. Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?. TJPH. 2022;20:177–185.
MLA Hekimoğlu, Can Hüseyin vd. “Standardized Infection Ratio: Can We Still Reliably Use the National Invasive Device- Associated Infection Models in Intensive Care Units in Turkey?”. Turkish Journal of Public Health, c. 20, sy. 2, 2022, ss. 177-85, doi:10.20518/tjph.989565.
Vancouver Hekimoğlu CH, Sahan S, Batır E, Yıldırım Gozel E, Altun D, Pehlıvanturk G, Comce M, Kara F. Standardized infection ratio: Can we still reliably use the national invasive device- associated infection models in intensive care units in Turkey?. TJPH. 2022;20(2):177-85.

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