关键词: 医院感染, 感染媒介, 多维连续时间马尔科夫链, 数值仿真

Abstract: Nosocomial infection is an important index of medical service quality. The existing literatures mainly study infection transmission based on the compartmental model, but fails to consider the status of discharged patients, which often overestimated the risk of systemic infection. To solve this problem, this paper proposes a research on the propagation and control of nosocomial infection based on multidimensional continuous-time Markov chain (MCTMC), so as to accurately depict the infection status and evolution process of patients and healthcare personnel. According to the characteristics of nosocomial infection transmission, infection vectors (healthcare personnel) were integrated into the mechanism of SIS (Susceptible-Infected-Susceptible ) to build a MCTMC-SIS model. By analyzing and comparing the state evolution rates of these two models, it is proved that the MCTMC-SIS model is advanced. Finally, the effectiveness of the control strategy is verified by numerical simulation, and the importance of parameters is evaluated. The results show that the rate of pathogenic bacteria on admission has a higher influence on the transmission of infection. When the rate is high (≥ 0.05), it is ineffective to reduce the risk of infection by improving the discharge rate of patients and the frequency of hand-washing. In actual infection control, infected patients need to be monitored in advance to reduce the risk of infection.

Key words: nosocomial infection, infection vectors, multi-dimensional continuous-time Markov chain (MCTMC), numerical simulation