Study On Current Status And Analysis Of Hospital Infection In One Hospital

Background and purpose:Hospital infection is a major problem in medical profession today. It will increase the suffering of patients, prolong their hospital stay, increase medical costs, and even lead to death. It is reported that about 100,000 cases of hospital infection occurred in UK each year, among which 5,000 were fatal, causing direct economic losses of up to 1.6 billion euros. While each year in USA, there are approximately 2 million hospital infections. 80,000 cases result in death, which lead to an additional cost of $ 4 billion per year. Extra mortality caused by nosocomial infections reach 4% ~33%, while the highest mortality is hospital-acquired pneumonia. According to a study in Argentina, VAP, BSI(CA-BSI), UTI cause mortality increased by 5%, 25% and 35%, respectively. Some studies in developed countries also show that every case of hospital infection can cause medical costs to increase by $ 1000~4500(an average of about $ 1,800) in pediatric, especially in NICU costs can be up to $ 10,000. Some studies on hospital infection economics loss show, cases of nosocomial infection per every dollar increase in fee ranging 2052~51447.38. Hospital infections will not only increase the suffering of patients, decrease the bed turnover rate, increase the mortality in patients, increase the burden of doctors, but also increase the economic burden on patients and a waste of medical resources.To summarize and analyze infection monitor, prevalence of hospital infection and distribution of pathogenic bacteria distribution and drug resistance is particularly important. This study is a comprehensive choice of a 3A hospital with 1,900 beds whose main source of the disease is from the surrounding counties. Being the largest hospital in the area, the hospital’s management philosophy and medical technology is more advanced, and its patients are of all ages who have various kinds of diseases. The hospital has more intensive care, such as ICU, neonatology, CCU, ICU, Respiratory intensive care unit, etc. There are more critically ill patients and patients with incurable diseases. Methods Of Research1. Data collection: A review of the medical records of all patients hospitalized in the period from January 2012 to December 2012. Collect basic patient information(gender, age, etc.), surgical cases, medication, hospitalization time, discharge time, hospital infection circumstances, situations, etc. pathogen susceptibility. Consult a large number of related documents.2. Isolation and identification of pathogens : According to the requirement of specifications and operating procedures "National Clinical Laboratory Procedures", the use of Walk Away 96 PLUS automated microbial identification / susceptibility test systems, submission of clinical specimens were cultured bacteria. Drugs and drug-sensitive paper plate used is produced by British OX company. The result was reached according to the standard of American Society for Clinical Laboratory Standards(Clinical and Laboratory Standards Institute, CLSI). Pseudomonas aeruginosa ATCC27853, Staphylococcus aureus ATCC25913 and Escherichia coli ATCC25922 were identified as quality control strains.3. Statistical analysis: Put the collected information into EXCEL2003, and use SPSS13.0 statistical software for statistical analysis of experimental results and records. Results1. The annual hospital infection rate was 3.24%, the daily hospital infection rate was 3.36‰ in 2012.2. The hospital infection rate was increased along with the growth of age(p< 0.01). The rate of the people elder than sixty is 5.89%, which is the highest of all the age groups; while the rate of the people between 0 to 14, 1.01%, was the lowest one. The infection rates of other age groups were as follow: the rate between 15 to 44 was 2.82%, and the rate between 45 to 59 was 3.13%.3. The difference of infection rate between men and women was statistically significant(p<0.01). The infection rate of male was 3.94%, which was higher than the female’s 2.87%.4. The incidence rate of hospital infection was different among the groups with different length of stay, and the difference is of great statistical significance(p< 0.01). The longer a patient stays in a hospital, the higher hospital infection rate was. Those who stayed in the hospital less than ten days with 1.59% to be the lowest hospital infection rate group, while more than 30 days group was the highest of all which was 10.71%. The rate of 11 to 20 days group was 3.89%, and the 21 to 30 days was 7.34%.5. Upper respiratory tract infection, infection of lower respiratory tract and urinary tract infection are the most common sites for hospital infection disease in 2012. The infection rate of them were 15.4%, 12.1%, 0.33%,respectivly. The total hospital infection rate was 3.42%.6. The hospital infection rate of each department ranked in the order: the respiratory intensive care unit(39.63%), the Intensive Care Unit(ICU)(28.21%), hematology department(21.21%), the third geriatrics department(19.87%), Rheumatism Immunity department(10.43%), the first endocrinology department(9.69%), the first geriatrics department(9.12%), the first urological department(8.70%), the emergency department(7.27%), the second urological department(6.81%), the second department of Cardiology(5.82%), the neurosurgery department(5.70%) the medicine oncology department(5.09%). ICU should be the key monitoring department for its highest hospital infection rate of all the department.7. The utilization rate of breathing machine, central venous cannula and Full-year 2012 ICU equipment utilization, utilization rate 46.24%, central venous cannula and catheter intubation of ICU was 31.92%, 93.84% in 2012. Equipment related hospital infection of ICU were the breathing machine related lung infection, the central vein intubation related blood infection and the urinary tract infection associated with catheter intubation. The incidences of these three diseases were 26.93%, 2.25% and 1.84%.8. As for neonatology department in 2012, the hospital infection rate of newborns whose weight were between 1001 to 1500 grams was 10.11%, which is the highest infection rate among all the newborns. There were no hospital infection occurred in the newborns less than 1000 gram. The utilization rate of umbilical/central venous cannula was 12.79%, and there was no related blood infection happened. The utilization rate of breathing machine was 4.55%, and the related pulmonary infection rate was 7.133 ‰. As for the breathing machine related lung infection, the newborns whose weight were between 1501 to 2500 grams with 15.69 ‰ ranked the first place, and the second one was 1001 to 1500 grams with 5.53 ‰. And no infections were found in the below 1000 gram and over 2500 grams. No umbilical/central venous cannula related infections were found.9. A total of 2261 bacterial strains were isolated, the top five pathogens were Escherichia coli(307 isolates, 13.6%), Klebsiella pneumoniae(267 isolates, 11.8%), Acinetobacter baumannii(226 isolates, 10.0%), Pseudomonas aeruginosa(203 isolates, 9.0%), Albicans Saccharomyces(129 isolates, 5.7%). Gram-positive bacteria were accounted for above 50% of all pathogens. Acinetobacter baumannii and Pseudomonas aeruginosa were decreased in resistance to imipenem in 2012. Klebsiella pneumoniae and Escherichia coli were sensitive to imipenem and β-Lactamaseinhibitors.Conclusions1. The hospital infection rate of this hospital met the national standards.2. Age, gender, and the length of hospital stay could affect the hospital infection rate in the hospital. The elder and longer hospital stay patients have the higher hospital infection rate. Male patients had much higher hospital infection rate than female patients.3. The upper and lower respiratory tract and urinary tract should be the key monitoring parts of hospital infection rate.4. ICU should be the key monitoring department for its highest hospital infection rate among all departments. The key items were the equipments related infection, including the breathing machine related lung infection, the central vein intubation related blood infection and the urinary tract infection associated with catheter intubation.5. Hospital infection is the main pathogenic bacteria of gram-negative bacteria. The top five pathogens were Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Albicans Saccharomyces.