Estimating the effect of hand hygiene compliance and surface cleaning timing on infection risk reductions with a mathematical modeling approach
Estimating the effect of hand hygiene compliance and surface cleaning timing on infection risk reductions with a mathematical modeling approach
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DOI：
10.1016/j.ajic.2019.05.023
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发表时间：
2019-12-01
影响因子：
4.9
通讯作者：
Canales, Robert A.
中科院分区：
文献类型：
--
作者：
Wilson, Amanda M.;Reynolds, Kelly A.;Canales, Robert A.
背景：需要定量工具来将感染控制干预措施与降低感染风险联系起来。方法：使用预测手头病毒浓度的模型来预测轮状病毒、鼻病毒和甲型流感病毒的剂量。包括行为的可变性，各种接触类型的转移效率，以及接触的表面积。剂量-反应曲线被用来将估计剂量与感染风险联系起来。结果：轮状病毒、鼻病毒和甲型流感病毒的基线平均感染风险分别为0.43、0.20和5.51×10(6)。清洁1次和2次的平均病毒感染风险分别降低6.98%~17.06%和13.95%~34.66%。手部依从性增加15%，平均感染风险降低6.98%-20.51%。增加15%的手部卫生依从性，加上2次清洁活动，平均感染风险降低20.93%-47.55%。讨论：本研究证实了联合干预的感染风险益处。结论：本研究中的模型可用于优化清洁活动的时间和频率，并制定手部卫生遵从性目标，以实现感染风险目标。(C)2019年感染控制和流行病学专业人员协会。由Elsevier Inc.出版。保留所有权利。
Background: Quantitative tools are needed to relate infection control interventions to infection risk reductions.Methods: A model for predicting virus concentrations on hands was used to predict rotavirus, rhinovirus, and influenza A virus doses. Variability in behaviors, transfer efficiencies for various contact types, and surface areas of contact were included. Dose-response curves were used to relate estimated doses to infection risks. Percent reductions from baseline in average rotavirus, rhinovirus, and influenza A virus dose and infection risk were calculated for interventions.Results: Baseline average infection risks for rotavirus, rhinovirus, and influenza A virus were 0.43, 0.20, and 5.51 x 10 (6), respectively. One and 2 cleaning events decreased average viral infection risks by 6.98%-17.06% and 13.95%-34.66%, respectively. A 15% increase in hand compliance decreased average infection risks by 6.98%-20.51%. A 15% increase in hand hygiene compliance paired with 2 cleaning events decreased average infection risks by 20.93%-47.55%.Discussion: This study demonstrates the infection risk benefits of combined interventions.Conclusions: Models such as the one in this study could be used to optimize timing and frequency of cleaning events and to create hand hygiene compliance goals to achieve infection risk targets. (C) 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.