| ObjectiveTo understand the infection and prevalence situation in hospital and community in one third level of first-class hospital and know well about the dynamic change of nosocomial infection and the impact factors about nosocomial infection regulation and evaluate the effects of nosocomial infection control. To discuss the epidemiology characters of nosocomial infection and reduce the risk factors which will contribute to provide reliable theoretical foundation for establishing the measures on nosocomial infection prevention and control.MethodsThis investigation studied to all hospitalized patients (including old and new hospital infection situation on discharge, move, died on 2010 May 190:00-24:00). Combined the besides the bed investigation method with the armour patients investigation to analyze the status of infection in the hospital. Investigation of nosocomial infection and community-acquired infection sites, pathogens cases, antimicrobial drug usage, risk factors for nosocomial infection, blood transmitted virus to carry and so on. Completed unified questionnaire, according to the "diagnostic criteria for nosocomial infection (Trial)"issued by Ministry of Health in 2001 issued, to determine whether patients were infected during hospitalization, and then determine the infection acquired in the hospital or community. All the infected patients were included in the state of infection during the survey.Quality control For each treatment area, conforming two investigators, a doctor and a nurse, asked both have intermediate professional titles. Investigators are composed by the hospital infection control professionals and clinical investigators. Investigators were trained by professionals before the survey, the training content was hospital infection diagnostic criteria, survey methods, questionnaire filled instructions. Each study subject should be investigated and fill out the survey questionnaires. After finishing all the surveys, data was checked by trained personnel, two people both processing data to ensure data accuracy. Statistics Methods Building a database using Excel, SPSS 13.0 was used to analyze the data. Count data was analyzed byχ2 test, P<0.05 was considered statistically significant.Results:2051 hospitalized patients were studied,2046 people were investigated actually, real check rate of 99.76%. Prevalence rate of nosocomial infection was 2.59%, nosocomial infection time prevalence rate was 2.83%. General ICU nosocomial infection prevalence rate was up to 44.44%, the highest was respiratory among internal medicine system, the highest was Neurosurgery among surgical systems. Community infection prevalence rate was 10.65%, prevalence of community-acquired cases was 11.34%, the prevalence of pediatric community-acquired was the highest of 95.24%. Usage of antimicrobial agents each day was 53.03%, for the purpose of treatment and prevention, drugs were used based on prevention in surgery, internal medicine, pediatrics for the treatment. TUE submission bacterial culture was 20.65%, 50.98% before treatment, pathogen detection rate was 74.51%, for the hospital infections and community-acquired infection, lower respiratory tract was in the first place. Post-operative pneumonia accounted for 17.54%. Hospital infection pathogens were mostly Candida albicans, accounting for 18.18%; community-acquired infection pathogens was mainly mycoplasma, accounted for 20.93. Hepatitis B, hepatitis C, anti-HIV testing rates in surgical departments are higher than non-surgical departments. Urinary catheter, vascular catheter, mechanical ventilation, tracheotomy, hormones, radiotherapy, chemotherapy, hemodialysis between used and unused difference is significant. The difference between gender, age, surgery, surgical incision type, the use of immunosuppressive agents and nosocomial infection were not significant. Patients with different underlying diseases suffering from a significant difference in infection, respiratory infection in hospital patients was the highest.Conclusion:1. Nosocomial infection prevalence rate was lower than the national level, comprehensive ICU is a high incidence department of nosocomial infection, comprehensive ICU, respiratory, neurological surgery, were the focus of hospital infection control. Prevalence of nosocomial infection was significantly higher than the results of routine monitoring of hospital infection, there were cases of infection omission, concealment phenomenon.2. Gender, age were independent from hospital infection, respiratory infection in hospital was the highest.3. lower respiratory tract infections are the main site among nosocomial infection and community-acquired infection. Pathogens are mainly from the lower respiratory tract. Candida albicans was the major one in hospital infection; mycoplasma for community-acquired infection.4. Antimicrobial drugs usage rate was higher than the national standard. Hospital drug was used for prevention, a high proportion of pure drugs, combination therapy is low. The purpose of drug usage in surgery, gynecology, obstetrics, ENT and other surgical departments is prevention, for treatment in internal medicine and pediatrics.5. Therapeutic use of antibiotics culture for pathogens submission rate is lower than the national average. Medication before the inspection is only half the rate of total submission, that submission is low pathogenic hospital, physician experience in medicine there.6. Hospitalized patients with HBsAg, anti-HCV, anti-HIV exam were more in surgical departments than non-surgical departments, the positive rate is not obvious.7. In the impact factors of nosocomial infection, the urinary catheter, vascular catheter, mechanical ventilation, tracheotomy, the use of hormones, radiotherapy, chemotherapy, hemodialysis were risk factors for nosocomial infection. Surgery, incision type, the use of immunosuppressive agents had no relation with the hospital infection. |
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