Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors.
Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors.
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DOI：
10.1371/journal.pone.0017144
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发表时间：
2011-02-28
期刊：
影响因子：
3.7
通讯作者：
Tozzi AE
中科院分区：
文献类型：
--
作者：
Isella L;Romano M;Barrat A;Cattuto C;Colizza V;Van den Broeck W;Gesualdo F;Pandolfi E;Ravà L;Rizzo C;Tozzi AE
医院感染给卫生保健系统带来了巨大的负担，并且是当前公共卫生中的主要问题之一，需要对其进行显著的预防努力。了解医院环境中感染传播的动态对于定制干预措施和预测个体之间的传播至关重要。数学模型需要有关于个人之间接触的准确数据。我们使用可穿戴有源射频识别设备（RFID）来检测个体之间的面对面接触，空间分辨率约为1.5米，时间分辨率为20秒。该研究在一家普通儿科医院病房进行，为期一周，包括119名参与者，51名医护人员，37名患者和31名护理人员。在研究期间记录了近16，000次接触，平均每位参与者每天约有20次接触。总体而言，25%的接触者涉及病房助理，23%的护士，22%的患者，22%的护理人员和8%的医生。大多数接触时间很短，但也发现了长期和频繁的接触，特别是病人和照顾者之间的接触。在所研究的环境中，照顾者并不代表感染传播给大量个体的显著潜力，因为他们的互动主要涉及相应的病人。由于护士在感染的潜在传播途径中发挥着核心作用，因此应优先考虑预防策略。我们的研究表明，在医院环境中的接触模式的准确和可重复的措施的可行性。所获得的结果对于研究呼吸道感染的传播、监测关键模式和制定有针对性的预防策略特别有用。接近传感技术应被视为一个有价值的工具，测量这种模式和评估医院的预防策略，在特定的设置。
Nosocomial infections place a substantial burden on health care systems and represent one of the major issues in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals. We used wearable active Radio-Frequency Identification Devices (RFID) to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants, with 51 health care workers, 37 patients, and 31 caregivers. Nearly 16,000 contacts were recorded during the study period, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found. In the setting under study, caregivers do not represent a significant potential for infection spread to a large number of individuals, as their interactions mainly involve the corresponding patient. Nurses would deserve priority in prevention strategies due to their central role in the potential propagation paths of infections. Our study shows the feasibility of accurate and reproducible measures of the pattern of contacts in a hospital setting. The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies. Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings.
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