ObjectiveTo explore the continuous changing trend of healthcare-associated infection prevalence rate in a children’s hospital.MethodsFrom July 2012 to November 2018, a cross-sectional survey was conducted to investigate the prevalence of healthcare-associated infections in hospitalized children for seven consecutive years by combining case-checking and bedside survey.ResultsA total of 10 310 hospitalized children were investigated in the past seven years. The incidence of healthcare-associated infections from 2012 to 2018 was 2.08%, 4.84%, 1.59%, 3.76%, 1.63%, 1.74%, and 2.08%, respectively, showing a statistically significant downward trend (LLA=7.631, P=0.006). The departments with higher proportion of healthcare-associated infections were pediatric surgery (50.0%), pediatric medicine (44.8%), neonatal medicine (2.8%), and intensive care units (2.4%) . Viruses (38.8%) were the most common pathogens of healthcare-associated infections, followed by Gram-negative bacteria (34.3%) .ConclusionsThe prevalence of healthcare-associated infections in the children’s hospital showed a downward trend year by year. Pediatric surgery is the most common occurrence department, and viruses are the most common pathogens. It can provide evidence for prevention and control of healthcare-associated infection in children’s hospitals.
ObjectiveTo investigate the incidence and trendency of healthcare-associated infections (HAIs) in a pediatric intensive care unit (ICU) of a hospital, identify the main objectives of infection control, and formulate corresponding preventive and control measures.MethodsA prospective targeted monitoring method was adopted to investigate HAIs in the pediatric ICU of a hospital from January 2013 to December 2018.ResultsFrom January 2013 to December 2018, the number of target ICU patients was 11 898, the number of patient-days was 55 159; 226 HAIs occurred, the HAI case rate was 1.90%, the incidence of HAI per 1 000 patient-days was 4.10‰, and the adjusted incidence of HAI per 1 000 patient-days was 1.21‰. The main infection site was respiratory tract [83 cases (36.7%)], with ventilator-associated pneumonia in 73 cases (32.3%); secondly, 69 patients (30.5%) had bloodstream infection, among which 48 (21.2%) had non-catheter-related bloodstream infection.ConclusionHospital targeted monitoring is helpful to grasp the situation and trend of HAIs, define the main target of infection control, and formulate corresponding preventive and control measures, which can effectively reduce the incidence of HAIs.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.
Healthcare-associated infections pose a significant challenge to healthcare institutions, severely threatening healthcare quality and patient safety. To enhance the quality of infection prevention and control across healthcare facilities at all levels, promote standardization, and drive continuous quality improvement, quality control centers for infection prevention and control have been established nationwide and have played a crucial role. This article conducts an in-depth analysis of the functions, current development status, and key challenges faced by these quality control centers throughout their evolution, aiming to provide insights for future advancements in quality control systems.
Healthcare-associated infection management has advanced rapidly in recent years. With the development of more standards and guidelines, infection control measures become more standardized and evidence-based. Evidence-based measures are increasingly applied in infection control, which promote more studies on the prevention and control of healthcare-associated infections. Furthermore, more new ideas of infection control have emerged, with old ones being challenged. The hand hygiene reform, multidrug-resistant organisms, and surgical site infections become the hot topics in recent years. In addition, whole-genome sequencing also provides more bases for understanding pathogen transmission in hospitals. Based on the high-quality studies published in recent years, this opinion review discusses these hot topics in the prevention and control of healthcare-associated infections.
This paper expounds the classification and characteristics of healthcare-associated infections (HAI) surveillance systems from the perspective of the informatization needs of HAI monitoring, explains the determination requirements of numerator and denominator in the surveillance statistical data, and introduces the regular verification for auditing the quality of HAI surveillance. The basic knowledge of machine learning and its achievements are introduced in processing surveillance data as well. Machine learning may become the mainstream algorithm of HAI automatic monitoring system in the future. Infection control professionals should learn relevant knowledge, cooperate with computer engineers and data analysts to establish more effective, reasonable and accurate monitoring systems, and improve the outcomes of HAI prevention and control in medical institutions.
Objective To construct a quality evaluation index system for healthcare-associated infection (HAI) management, and conduct an empirical evaluation on the quality of HAI management in clinical departments. Methods The literature research method and panel discussion method were adopted to initially form the framework of HAI management quality evaluation index system, and the Delphi method and the analytic hierarchy process were used to establish the index system and determine the weights from January to December 2018. Eight comprehensive evaluation methods, such as osculating value method and technique for order preference by similarity to an ideal solution method, were used to evaluate the quality of HAI management in clinical departments of West China Hospital, Sichuan University in 2018. Kendall’s coefficient of concordance (W) was used to assess the consistency of the results. The clinical departments were ranked by the standardized total scores, which were the means of the normalized scores of the eight methods. Results A quality evaluation index system for HAI management with 3 first-level indicators and 15 second-level indicators was established finally. The results of the eight comprehensive evaluation methods for the quality evaluation of HAI management in 39 clinical departments of West China Hospital, Sichuan University were consistent (W=0.952, χ2=259.800, P<0.001). The standardized total score of Department 18 was 100, which ranked the first place. Conclusion The HAI management quality evaluation index system constructed in this study could be used in clinical departments to evaluate the quality of HAI management in combination with comprehensive evaluation methods.
This article provides a thorough interpretation of the recommendations for implementation research in healthcare-associated infection (HAI) prevention and control, jointly issued by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, and the Association of Professionals in Infection Control and Epidemiology. The recommendations elaborate on the concepts, strategies, determinants, and evaluation methods of implementation research, as well as the commonly used theories, models, and frameworks (TMF) in the field of HAI prevention and control. By expounding on these TMF, this article aims to guide readers in deeply considering the scientific issues related to the implementation of hospital infection prevention and control, and to provide guidance on selecting and applying appropriate resources in specific environments and situations. The release of these recommendations aims to promote the implementation of evidence-based guidelines in medical institutions and ultimately achieve the goal of reducing the incidence of hospital infections by promoting and guiding the conduct of implementation research in the field of HAI prevention and control.
Healthcare-associated infection outbreaks are a serious threat to patient safety and often cause serious consequences. The use of genotyping methods to identify the source of infection and the route of transmission in outbreaks is a critical point in controlling outbreaks. Recently, the use of whole-genome sequencing (WGS) makes it faster and much more accurate. Compared with traditional methods, WGS can distinguish highly correlated pathogen lineages, track infection source accurately and help researchers understanding the propagation dynamics model, and even provide more target intervention information. The application of WGS technology in healthcare-associated infection outbreak investigation and control is reviewed in this paper, and its advantages and challenges are also evaluated.
ObjectiveTo measure and evaluate the economic burden of hospital infection in Sichuan, and provide a basis for targeted economic evaluation of healthcare-associated infection (HAI).MethodsIn hospitals participating in the 2016 Sichuan provincial prevalence survey of HAI, matched cases were used to extract cases and controls, and then a multi-center nested case-control study was conducted.ResultsA total of 225 pairs/450 patients were selected in 51 hospitals, and 175 pairs/350 patients were successfully matched. The median of the difference of hospitalization costs between matched-pairs were RMB 3 362.0, and the difference was statistically significant (Z=3.275, P<0.001).ConclusionsThe hospitalization costs caused by HAI should be given special attention in the current medical insurance reform. Efforts need to be taken to reduce the hospitalization costs caused by HAI.