The association between clinical drug utilization and the risk of nosocomial infections among inpatients:a comprehensive dose-response analysis
10.16718/j.1009-7708.2025.02.001
- VernacularTitle:住院患者临床用药与医院感染发生风险的相关性及剂量-反应分析
- Author:
Xiaoliang ZHANG
1
;
Fangbin LI
;
Xiaolong YUAN
;
Yujuan FENG
;
Haimo WANG
;
Xiaoyong LIN
;
Bingpeng WEI
;
Lei WANG
;
Haojun ZHANG
Author Information
1. 甘肃省第二人民医院公共卫生与医院感染管理科,兰州 730000
- Publication Type:Journal Article
- Keywords:
nosocomial infection;
proton pump inhibitor;
immunosuppressant;
antimicrobial agent
- From:
Chinese Journal of Infection and Chemotherapy
2025;25(2):121-126
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the relationship between clinical drug utilization and the risk of nosocomial infections among hospitalized patients,and provide evidence for the prevention and control of nosocomial infections.Methods This study adopted a retrospective case-control design.The case group included 209 patients with nosocomial infection reported from January 2023 to December 2023 in a tertiary hospital.The control group included 209 patients without nosocomial infection during the same period.The patients in the control group were selected by stratified sampling based on Charlson Comorbidity Index(CCI).Results Univariate analysis showed that proton pump inhibitors,antacids,immunosuppressants and prior antimicrobial combination therapy increased the risk of nosocomial infection(P＜0.05).Multivariate log-binomial regression analysis showed that proton pump inhibitors,immunosuppressive drugs,and prior antimicrobial combination therapy were correlated with nosocomial infection.The corresponding relative risk(RR)was 1.31(95％CI:1.07-1.60),1.40(95％CI:1.02-1.91),and 1.66(95％CI:1.01-2.74),respectively.Further analysis indicated that the patients with nosocomial infection had longer time in use of proton pump inhibitors and prior antimicrobial combination therapy than the patients in the control group(Z=-6.331,P＜0.001;Z=-2.667,P=0.008).The trend Chi-square test showed that there was a dose-response relationship for proton pump inhibitors(x2=73.869,P＜0.001),immunosuppressive drugs(x2=16.530,P＜0.001),and prior antimicrobial combination therapy(x2=35.107,P＜0.001).Conclusions The use of immunosuppressants,proton pump inhibitors and antimicrobial combination therapy increases the risk of nosocomial infections in hospitalized patients.The prolonged use of these drugs will further increase the risk of nosocomial infection.
