Prevalence Study And Influence Factors Of Nosocomial Infection In ICU Of The Hospital In Jincheng Anthracite Mining Group

Objective:With the investigation of the prevalence and influence factors of nosocomial infections in Intensive Care Unit (ICU), the three purposes are:(1) get acquainted with the morbidity and affected part of nosocomial infections in ICU; (2) understand pathogens distributing and the transformation characteristics of drug resistance with regard to nosocomial infection in the ICU, in order to provide a scientific basis for guiding the clinic rational application of antibiotics; (3) explore the risk factors for Nosocomial Infection in the ICU.Methods:According to the methods of "adult and pediatric nosocomial infections surveillance in the ICU" from standard for nosocomial infection surveillance, issued by the Ministry of Health, a total of 365 patients who were in the ICU from September 1,2008 to December 31,2009 are in prospective surveillance. Fill out a uniform questionnaire, including general content and the content related factors of nosocomial infections. Diagnostic standard of nosocomial infection is used with Diagnostic standard of Nosocomial Infection issued by the Ministry of Health of the People's Republic of China. All date are processed by the software of SPSS13.0 with the test levelα= 0.05.Results:The morbidity of nosocomial infection in the ICU is 11.23%. The primary infection rate is 16.44%. The first three parts of infection sites are respiratory tract, surgical incisions and skin soft tissue. Respiratory tract is the highest, accounting for 50.00%. Ventilator-associated pneumonia accounts for 56.67%of the infection rate of respiratory tract among them. The main pathogen of nosocomial infections is Gram negative bacilli, accounting for 81.25%. The others are Gram positive cocci accounting for 10.94%and fungi accounting for 7.81%.The former three of Gram negative bacilli are pseudomonas aeruginosa, acinetobacter baumannii and escherichia coli. Gram negative bacilli is highly sensitive to imipenem, meropenem and piperacillin/tazobactam, while it has drug resistance of varying degrees for other antibiotics; Chi-square test of related factors on nosocomial infections shows that emergency surgery, tracheotomy, deep venous catheter, Long hospitalization, mechanical ventilation time and the condition when into the ICU are the associated factors of infection in the ICU. Non-conditional logistic regression multivariate analysis shows that long hospitalization and mechanical ventilation time are the independent risk factors of nosocomial infections.Conclusion:the incidence rate of nosocomial infections in the ICU is higher than in the common ward. nosocomial infections control should be strengthened, thereby reducing the overall level of nosocomial infections in the ICU. The respiratory tract is still the main Site of nosocomial infections in the ICU; various measures should be actively adopted to reduce the morbidity of ventilator-associated pneumonia. The main pathogen of nosocomial Infections in the ICU is Gram negative bacilli, difffer by infection sites. There are a mass of drug-resistant strains. Variations of pathogens should be in control for the rational use of antibiotics in ICU as a guide in order to reduce the production of bacterial drug resistance. Adopt comprehensive prevention and cure measures for nosocomial infections in the ICU, improve the quality of medical treatment and guarantee the sufferer safety.