Analysis Of Surveillance On The Efficacy Of Disinfection From Three Hospitals In Shanghai During 2010-2012

ObjectiveTo study and evaluate the disinfection quality of hand hygiene and environment and the distribution of pathogens isolated of 3 hospitals in Shanghai, and find out the risk factors of nosocomial infections, which will provide basis for improving hospital disinfection and controlling nosocomial infections.MethodsSamples including hand hygiene, surfaces, air bacterial concentration of operating room, dental unit waterlines (DUWL), endoscope, medical sewage and autoclave were collected every quarter during 2010 to 2012 from 3 hospitals in Shanghai. The eligible rate of disinfection and risk factors were analyzed and pathogens of samples were isolated and identified.Results1. The efficacy of disinfection of hand hygiene558 samples of hand hygiene were collected with the overall eligible rate of 84.41%, in which the eligible rate of 211 surgery hand samples were 93.84% and the eligible rate of 347 handrubbing samples were 78.67%. The eligible rate of surgery hand samples was higher than that of handrubbing samples (χ2=22.928, P<0.001). Time of hands disinfection of the staff in operating room was between 80 to 240 seconds,156 seconds on average. The eligible rate of samples disinfected within 120 seconds was 90.00%, while the eligible rate of samples disinfected over 120 seconds was 97.3.0%(χ2=4.845, P<0.05). The eligible rates of handrubbing in pediatric ward, special ward, nurse station, ICU and maternity ward were all over 90%, while the eligible rates of handrubbing in outpatient, dental and neonatal room were lower. According to the hand hygiene behavior of staff, the eligible rate of handrubbing with handwashing was 79.30% while the eligible rate of handrubbing with disinfection was 77.50%. The eligible rate of handrubbing disinfected over 60 seconds was higher (χ2=4.483, P<0.05). The eligible rate of handrubbing dried with disposable paper towel was higher than that dried with towel (χ2=11.191, P<0.01).2. The efficacy of disinfection of hospital environment1615 samples were collected with the overall eligible rate of 72.38%, and the eligible rate increased every year (χ2=24.18, P<0.01). The eligible rates of autoclave and medical sewage were 100% and 94.44% separately. The eligible rates of endoscope, DUWL, air bacterial concentration of operating room were 54.10%, 65.42%, and 66.01% separately. The eligible rate of surfaces was 76.97%. The surfaces eligible rates of ICU, surgical ward, pediatric ward were worst. Door handles/armrests were most serious.3. Distribution of pathogens isolated95 pathogens were isolated from monitoring samples, with the gram-positive bacteria accounting for 24.2% and the gram-negative bacteria accounting for 75.8%. The most common bacteria were Staphylococcus aureus (7) among the gram-positive bacteria. The most common bacteria were Escherichia coli(11) among the gram-negative bacteria. The department detected pathogens were focused on stomatology and ward. The percentages of detection of pathogens on desktop/countertops and door handles/armrests were 51.6% and 25.8%, which were higher among different sampling objects.Conclusion1. The eligible rate of surgey hands was higher than that of handrubbing. The eligible rate of hand hygiene could be raised by prolonging the time of handwashing. The eligible rate of handrubbing could also be raised by drying hands with disposable paper towel. Management of departments with low eligible rate of hand hygiene would be strengthened.2. There were many problems in the disinfection and sterilization of 3 hospitals with a low overall eligible rate. DUWL, endoscope and air bacterial concentration of operating room woule be closely monitored.3. The gram-positive bacteria were the most common bacteria in the pathogens from hospitals. The disinfection in key departmens and key sites would be strengthened to reduce the risk of pathogen contamination.