배경：중앙대학교병원의 신축이전을 계기로 병원환경의 변화가 병원-획득성 요로감염에 미치는 영향을 평가하고자, 구병원(필동)과 신축병원(흑석동)에서 발생한 요로감염 환자를 대상으로 병원-획득성 요로감염의 감염률과 위험요인을 분석하여 보았다. 방법：요배양 검사에서 양성인 환자의 병록지 조사를 통하여, 2003년 7월부터 2004년 6월까지 중앙대학교 구병원(필동)과 2005년 1월부터 2005년 12월까지 신축병원(흑석동)의 요로감염 환자를 대상으로 병원-획득성 요로감염률과 위험요인을 후향적으로 분석하였다. 병원-획득성 요로감염은 입원 48 시간 이후 1가지 또는 2가지 균주가 105 colony-forming units (CFUs)/mL 이상 배양된 경우로 정의하였다. 위험요인은 성별, 연령, 입원기간, 진단명(악성종양, 만성질환, 당뇨 등), 중환자실에서의 치료 여부, 면역 상태, 신장기능, 카테터 삽입여부, 운동제한여부 등을 포함하여 조사하였다. 결과：병원-획득성 요로감염률은 구병원과 신축병원에서 각각 2.9% (206건/7,088명)와 2.0% (289건/14,704명)로 신축병원에서 유의하게 감소하였다(P<0.05). 그러나 병원-획득성 요로감염 환자들의 위험 요인 분석에서는 양 병원 간 통계적으로 유의한 차이가 없는 것으로 나타났다(P>0.05). 결론：구병원과 동일한 의료인, 검사자, 검사방법을 유지한 상태로 이전한 신축병원에서 요로감염의 위험요인과 관련된 요소들의 차이가 없음에도 불구하고 병원-획득성 요로감염률이 유의하게 감소하였다. 이는 새로운 기구와 장비를 포함한 병원 환경의 변화에 의해 병원-획득성 요로감염률이 감소하였다고 사료된다.

Background: To estimate the influence of a change in the hospital environment on a hospital-acquired urinary tract infection (HAUTI), we analyzed and compared the rates of HAUTI and the associated risk factors between an old hospital (Phil-dong) and a new hospital (Heucksuck-dong) of Chung-Ang University. Methods: Retrospective studies of patients with urinary tract infection were conducted at the old and new hospital during the period from July 2003 to June 2004 and from January to December 2005, respectively. HAUTI was defined as the isolation of one or two microorganisms at greater than 105 CFUs/mL from urine at 48 hours or more after admission. The risk factors of HAUTI included sex, age, duration of hospitalization, as well as malignancy, chronic disease, diabetes mellitus, intensive care unit care, immune deficiency, renal function, Foley catheterization, and immobility. Results: The rates of HAUTI at the old and new hospital were 2.9% (206 cases per 7,088 patients) and 2.0% (289 per 14,704), respectively (P<0.05), but there were no statistical differences in the associated risk factors between the two hospitals (P>0.05). Conclusion: Although both the old and new hospitals were served by the same health-care staff and inspectors using the same methods, the rate of HAUTI was significantly lower at the new hospital. This suggests that a change of the hospital environment, including new instruments and equipment, has an influence on the rate of HAUTI.

Background: To estimate the influence of a change in the hospital environment on a hospital-acquired urinary tract infection (HAUTI), we analyzed and compared the rates of HAUTI and the associated risk factors between an old hospital (Phil-dong) and a new hospital (Heucksuck-dong) of Chung-Ang University. Methods: Retrospective studies of patients with urinary tract infection were conducted at the old and new hospital during the period from July 2003 to June 2004 and from January to December 2005, respectively. HAUTI was defined as the isolation of one or two microorganisms at greater than 105 CFUs/mL from urine at 48 hours or more after admission. The risk factors of HAUTI included sex, age, duration of hospitalization, as well as malignancy, chronic disease, diabetes mellitus, intensive care unit care, immune deficiency, renal function, Foley catheterization, and immobility. Results: The rates of HAUTI at the old and new hospital were 2.9% (206 cases per 7,088 patients) and 2.0% (289 per 14,704), respectively (P<0.05), but there were no statistical differences in the associated risk factors between the two hospitals (P>0.05). Conclusion: Although both the old and new hospitals were served by the same health-care staff and inspectors using the same methods, the rate of HAUTI was significantly lower at the new hospital. This suggests that a change of the hospital environment, including new instruments and equipment, has an influence on the rate of HAUTI.

Urinary tract infection, Hospital-acquired infections, Infection rate, Hospital environment