Objective To investigate the prognostic factors and hospitalization cost in patients diagnosed as central line-associated bloodstream infection( CLABSI) in intensive care unit( ICU) .Methods A retrospective study was made to investigate the CLABSI epidemic data in ICU from June 2006 to June 2009. Clinical and physiological parameters were summarized and compared between these patients, which were divided into two groups based on the clinical outcome. Meanwhile, events including blood transfusion,mechanical ventilation, as well as cost of hospitalization were also reviewed. Logistic regression method was introduced to investigate the potential prognostic risk factors. Results There were 49 patients were diagnosed as nosocomial CLABSI, in which 19 cases( 38. 8% ) died in the hospital and 30( 61. 2% ) weresurvival. In univariate analysis, differences in body temperature, central venous pressure, acute physiology and chronic health evaluation( APACHEⅡ ) score, blood transfusion amount, pH value, D-dimer, blood serum alanine transarninase, blood urea nitrogen level, serumcreatinine, serumpotassiumbetween the survivors andthe non-survivors were significant( P lt;0. 05) . However, no significant differences were observed between the two groups in in-hospital days, ICU days and hospitalization cost ( all P gt; 0. 05) . With multiple logistic regressions, higher APACHEⅡ score( OR 0. 78; 95% confidence interval: 0. 66-0. 94; P = 0. 007) , APTTlevel( OR 0. 87; 95% confidence interval: 0. 77-0. 98; P = 0. 026) and serum potassium( OR 0. 09; 95% confidence interval: 0. 01-0. 80; P = 0. 031) were independent predictors of worse outcome. Conclusions Disease severity and coagulation situation may directly predict the prognosis of nosocomial CLABSI patients.But current investigation did not demonstrate significant differences in ICU length of stay and respective cost between the CLABSI patients with different prognosis.
ObjectiveTo investigate the incidence of nosocomial infection in acute and serious schizophrenic inpatients and its risk factors. MethodsBetween January 1st and December 31st, 2012, we investigated 1 621 schizophrenic patients on the status of nosocomial infections according to the hospital standard of nosocomial infection diagnosis. They were divided into infected group and uninfected group according to the survey results. The risk factors were analyzed by logistic regression method. ResultsTwenty-nine infected patients were found among the 1 621 patients, and the incidence rate was 1.79%. Among the nosocomial infections, the most common one was respiratory infection (79.31%), followed by gastrointestinal infection and urinary infection (6.90%). There were significant differences between the two groups of patients in age, hospital stay, positive and negative syndrome scale (PASS), combined somatopathy, the time of protective constraint, modified electraconvulsive therapy (MECT), using two or more antipsychotics drugs, using antibiotics and side effects of drugs (P<0.05). However, there were no statistical differences in gender, age classes, the course of disease, frequency of hospitalization and seasonal incidence of hospital infection (P>0.05). The results of multivariate analysis showed that hospital stay, positive symptom score, negative symptom score, the time of protective constraint, MECT, using two or more antipsychotics drugs and side effects of drugs were the main risk factors for nosocomial infection of inpatients with psychopathy (P<0.05). ConclusionBased on the different traits and treatments of acute and serious schizophrenia, a screening table of infections should be set. For the high risk group of nosocomial infection, effective measures should be taken to prevent and control the nosocomial infection of patients with schizophrenia.
ObjectiveTo analyze targeted surveillance results of nosocomial infection in Neurosurgical Intensive Care Unit (ICU) and investigate the characteristics of nosocomial infection, in order to provide reference for constituting the intervention measures. MethodsWe monitored the incidence of nosocomial infection, the application and catheter-related infection of invasive operation, and the situation of multiple resistant bacteria screening and drug resistance characteristics of each patient who stayed more than two days in neurosurgical ICU during January to December 2013. ResultsThere were a total of 1 178 patients, and the total ICU stay was 4 144 days. The nosocomial infection rate was 4.92%, and the day incidence of nosocomial infection was 13.75‰. The nosocomial infection rate was significantly higher in January and between July and December compared with other months. Ventilator utilization rate was 9.75%; ventilator-associated pneumonia incidence density was 14.85 per 1 000 catheter-days; central line utilization rate was 28.40%; central line-associated bloodstream infection incidence density was 0.85 per 1 000 catheter-days; urinary catheter utilization rate was 97.90%; and the incidence density of catheter-associated urinary tract infection was 0.25 per 1 000 catheter-days. ConclusionThe nosocomial infection rate has an obvious seasonal characteristic in neurosurgical intensive care unit, so it is necessary to make sure that the hospital infection control full-time and part-time staff should be on alert, issue timely risk warning, and strengthen the risk management of hospital infection.
At present, the mode of day surgery has been widely carried out in China. With the rapid turnover of patients, higher requirements have been put forward for the management of nosocomial infection. Therefore, it needs norms for the management of nosocomial infection in the day surgery ward. After 10 years of precipitation, under the guidance of the hospital infection management department, the hospital infection management system for the day surgery ward of West China Hospital of Sichuan University has been continuously researched and explored, so as to ensure the rapid turnover of patients and make the hospital infection management meet the national standards. The system includes patient management and control, environmental management and control, matters needing attention of medical staff, surgical site infection data collection, and indicators of hospital infection supervision, etc.
ObjectiveTo analyze the trend of hospital infection, so as to provide a scientific basis for hospital infection prevention and control. MethodsFrom 2011 to 2013, according to the criteria of diagnosis of nosocomial infections set up by the Ministry of Health, the prevalence rates of nosocomial infections in patients who were hospitalized on the survey day were investigated by the combination of bedside investigation and medical records checking. ResultsThe incidence rates of nosocomial infections from 2011 to 2013 were 2.99%, 2.31% and 1.95%, respectively, presenting a downward trend. The rate of hospital infection was the highest in comprehensive Intensive Care Unit, and the main infection site was the lower respiratory tract. Gram-negative bacteria were the main pathogens causing hospital infections, including Klebliella pnermoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Escherichia coli. The utilization rates of antibacterial agents in these three years were respectively 39.84%, 34.58% and 34.22%. ConclusionTargeted surveillance and management of key departments and sites should be strengthened. It is necessary to strengthen the surveillance and management of antibiotics, raise the submission rate of pathogens, and use antibiotics appropriately.
ObjectiveTo find out the major isolates distribution, drug resistance changes of multidrug-resistant organisms (MDRO) in 2013 for rational use of antibiotics and hospital infection control. MethodsA total of 32 566 cultured bacteria samples from the patients diagnosed between January 1st and December 31st 2013 were collected, using conventional tube biochemical assays and semi-automatic automicrobic (AMS) for bacteria identification; and antimicrobial susceptibility testing, major drug resistance mechanism detection were performed according to CLSI documents. MDRO definition was made according to the 2011 international consensus from European Center for Disease Control and Prevention (CDC), American CDC, Clinical and Laboratory Standards Institute (CLSI), and Food and Drug Administration. The data was analyzed by WHOnet 5.6 software. ResultsWe got 3 684 strains isolates, G- accounted for 76.08%, G+ 16.80%, fungi 7.11%, and fastidious bacteria 17.29%. The top ten isolates in order were:E.coli, A.baumannii, Ps.aeruginosa, H.influenzae, K.pneumoniae, S.aureus, S.pneumoniae, A.fumigatus, M.catarrhalis and C.freundii. From the first quarter 2012 to the fourth quarter 2013, the extended spectrum β lactamases (ESBL)-producing E.coli increased from 40.23% to 53.54%, ESBL-producing K.pneumonia increased from 14.28% to 34.78%, XDR-A.baumannii increased from 62.38% to 99.25%, metalloenzyme-producing Ps.aeruginosa increased from 7.37% to 25.37%, methicillin resistant staphylococcus aureus increased from 23.81% to 58.70%, and VRE increased from 0.00% to 28.12%. ConclusionIn the isolates, the percentage of G- was the highest, and the rate of MDRO are all unremittingly raising, which suggests us should pay more attention to microbiology analysis, rational use of antibiotics, strengthening hospital infection control, reducing the bacterial resistance, and strengthening MDRO surveillance.
Objective To analyze morbility，risk factors，etiology，treatment and outcome of nosocomial pulmonary fungal infections in respiratory intensive care unit（RICU）.Methods Forty-seven respiratory RICU patients with nosocomial pulmonary fungal infections between July 2000 and June 2005 were retrospectively analyzed.Results All of the 47 cases were clinically diagnosed as probable nosocomial pulmonary fungal infections，with the morbidity of 10.8% significantly higher than general wards（1.8%，Plt;0.005）.COPD and bacterial pneumonia were the major underlying diseases of respiratory system with a percent of 38.30% and 36.17%，respectively.Forty-one patients (87.2%) had risk factors for fungal infections.Compared with general wards，the proportion of Aspergillosis was higher in RICU without significant difference (Pgt;0.1)；the proportions of Candida glabrata and Candida tropicalis were higher too，but that of Candida krusei was relatively low.The effective rate of antifungal treatment was 79.1% and fluconazol was the most common used antifungal agents.The mortality of fungal infection in RICU was higher than that of general wards but without significant difference（Pgt;0.1）.Conclusion The morbidity of nosocomial pulmonary fungal infection in respiratory RICU is higher than that in general wards.The proportions of infection caused by Aspergilli and some Candida resistant to fluconazol is relatively high.Early and effective treatment is needed in these patients considering the poor prognosis.
ObjectiveTo understand the characteristics of and risk factors for nosocomial infection in a newly built branch of a university teaching hospital, in order to investigate the control measures for prevention and control of nosocomial infection. MethodsA total of 598 cases of nosocomial infection from April 2012 to June 2014 were enrolled in this study. We analyzed statistically such indexes as nosocomial infection rate, infection site, pathogen detection, and use of antibiotics. Meantime, infection point-prevalence survey was introduced by means of medical record checking and bedside visiting. ResultsAmong all the 44 085 discharged patients between April 2012 and June 2014, there were 598 cases of nosocomial infection with an infection rate of 1.36%. Departments with a high nosocomial infection rate included Intensive Care Unit (ICU) (9.79%), Department of Orthopedics (2.98%), Department of Geriatrics (2.62%), and Department of Hematology (1.64%). The top four nosocomial infection sites were lower respiratory tract (45.32%), urinary tract (13.21%), operative incision (8.86%), and blood stream (8.86%). The samples of 570 nosocomial infections were delivered for examination with a sample-delivering rate of 95.32%. The most common pathogens were acinetobacter Baumanii (17.02%), Klebsiella pneumoniae (14.21%), Escherichia coli (13.68%), Pseudomonas aeruginosa (11.93%), and Staphylococcus aureus (9.12%). And urinary tract intubation (42.81%), admission of ICU (28.60%), and application of corticosteroid and immunosuppressive agents (26.42%) were the top three independent risk factors for nosocomial infection. ConclusionGeneral and comprehensive monitoring is an effective method for the hospital to detect high-risk departments, factors and patients for nosocomial infection, providing a theoretical basis for prevention and control of nosocomial infection.
Objective To understand the current situation of nosocomial infection management quality control centers at the municipal and county levels in Guizhou, so as to provide measures for promoting the construction of nosocomial infections management quality control centers at all levels in Guizhou. Methods From September 26th to October 12th 2023, based on the mobile network platform survey questionnaire of the infection prevention and control workshop, a survey was conducted on the establishment, personnel, information technology level, management, and quality control work of the nosocomial infection management quality control centers at the municipal and county levels in Guizhou. Results Nine prefecture-level cities/autonomous prefectures in Guizhou had established municipal-level nosocomial infection management quality control centers. The professional background of the staff at the municipal and county-level quality control centers was mainly nursing (accounting for 36.4% and 58.4%, respectively), and their educational background was mainly undergraduate (accounting for 70.5% and 83.3%, respectively). No quality control center at the municipal or county level had established an information-based quality control platform for nosocomial infection management within the region. Most county-level quality control centers did not have special funds (87.5%), and there were still 16 (25.0%) county-level quality control centers that had not established relevant systems for work and management. The main forms of quality control work carried out by each center were organizing training, on-site inspections, guidance and evaluation, and most of them were conducted irregularly. Conclusions Guizhou has basically formed a quality control system for nosocomial infection management at the provincial, municipal, and county levels. However, the nosocomial infection management quality control network has not fully covered all districts, and policies, funding support, and personnel allocation are still insufficient. Health administrative departments and quality control centers at all levels need to unify monitoring standards and quality control norms, strengthen supervision, improve quality control capabilities, and improve training systems to achieve standardization and normalization of quality control work throughout the province and improve quality control efficiency.
ObjectiveTo explore the distribution of multidrug resistant organism in neonates admitted to the hospital through various ways, and analyze the risk factors in order to avoid cross infection of multidrug resistant organism in neonatology department. MethodsA total of 2 124 neonates were monitored from January 2012 to July 2013, among which 1 119 were admitted from outpatient department (outpatient group), 782 were transferred from other departments (other department group), and 223 were from other hospitals (other hospital group). We analyzed their hospital stays, weight, average length of stay, and drug-resistant strains, and their relationship with nosocomial infection. ResultsAmong the 105 drug-resistant strains, there were 57 from the outpatient group, 27 from the other department group, and 21 from the other hospital group. The positive rate in the patients transferred from other hospitals was the highest (9.42%). Neonates with the hospital stay of more than 14 days and weighing 1 500 g or less were the high-risk groups of drug-resistant strains in nosocomial infection. Drug-resistant strains of nosocomial infection detected in the patients admitted through different ways were basically identical. ConclusionWe should strengthen screening, isolation, prevention and control work in the outpatient neonate. At the same time, we can't ignore the prevention and control of the infection in neonates from other departments or hospitals, especially the prevention and control work in neonates with the hospital stay of more than 14 days and weighing 1 500 g or less to reduce the occurrence of multiple drug-resistant strains cross infection.