| ObjectiveThe purpose of this study was to use the descriptive, analytical epidemiological method to investigate the nosocomial infection data in a hospital from2009to2011, analysis of the nosocomial infection prevalence, epidemiological characteristics, and the influencing factors of nosocomial infection, which can provide the basis and recommendations for the formulate the control measures or policies of nosocomial infectionMethods1.Select a teaching hospitals, investigate the nosocomial infection prevalence for three consecutive years from2009to2011.2.The three-year investigation was carried out in a unified method in accordance with unified national nosocomial infection cross-sectional study organized by the Ministry of Health Hospital Infection Control training monitoring base. The survey was taken a method combined bedside one by one the survey with medical investigation, the nosocomial infection prevalence survey form filled out order by the bed.3.The results were analyzed by the software spssl3.0, nosocomial infection prevalence rate, age distribution, sex distribution, anatomical site, sections of the distribution, the pathogens detected were statisticed and descriptive analysised, The qualitative data using the χ2distribution test, and quantitative data were analyzed by t-test or non-parametric tests. The criteria of statistically significant differences is P<0.05.Using the spss, analysised the data by the univariate analysis at first, and then analysised the selected statistically significant variables that derived from the univariate analysis by the non-conditional logistic regression model,screened the independent risk factors of nosocomial infection.Results1.The three nosocomial infection investigation from2009to2010should investigate5431people, in fact, investigate5431, the investigation rate was100%,with3104males and2327females, The ratio of male to female was1.36:1; The average age was47.07years old. The infection number was255, the infection prevalence was4.70%; infection cases number was272, the infection case rate rate was5.01%, the infection rate was4.64%in2009, the infection cases were89, case rate was5.17%; the infection rate was4.83%in2010, the infection cases were88, the infection case rate was4.88%; In2011, the infection rate was4.62%, the infection cases95, the infection case rate is4.98%;the difference between the three years was not statistically significance.2.The top ten depts of the nosocomial infection prevalence infection rates were Critical Care Medicine35%(14/40), laminar flow ward31.58(6/19), Hematology,15.95%(26/163), Rehabilitation12.17%(14/115), burn unit11.11%(3/27), neurosurgery8.43%(38/451), paediatrics7.68%(36/469), Neurology,7.58%(32/422), oncology4.57%(18/394), general surgery4.54%(20/441).3.The nosocomial infection rate in the age dimension was roughly "U" shaped distribution, After35-year-old age group, the nosocomial infection prevalence rate increased with age. the nosocomial infection prevalence of each age group was incomplete the same,the difference was statistically significant (χ2=22.487,P=0.013). 4.The nosocomial infection prevalence of male patients was5.12%,4.04%in female patients, the difference was not statistically significant. Lower respiratory tract infection prevalence of male patients was higher than that of females, the difference was statistically significant (χ2=5.596,P=0.018). Urinary tract infection prevalence of male patients was0.52%and1.12%of female patients, the difference was statistically significant (χ2=6.278, P=0.012), urinary tract infection prevalence of male patients was lower than female’s. Blood system infection prevalence of male patients was0.48%and0.39%of female patients, the difference was not statistically significant (χ2=0.281, P=0.596), blood system infection prevalence between male patients and female patients was not different。5.Divided into five groups, according to the length of hospitalization. The nosocomial infection prevalence of≤8-day group was0.57%,4.76%of9-16days group which was8.07times higher than≤8-day group, The nosocomial infection prevalence of17-30days group was7.65%,14.40%of31-60days group,18%of>61days group, the difference was statistically significan(χ2=321.64,,P=0.000).6.The number of surgical patients with infection was86, the prevalence rate was5.85%, the number of non-surgical patients with infection was169, the prevalence rate was4.66%,χ2=5.974, P=0.015, the difference was statistically significant, the prevalence rate of surgical patients was higher than non-surgical patients.7.The univariate analysis showed that the risk factors associated with nosocomial infection were age, lengh of hospitalization, surgery, diabetes, coma, chemotherapy, hormonal, vascular catheter, urinary catheter, endotracheal intubation and ventilator. Non-conditional stepwise logistic regression model showed that the seven risk factors associated with nosocomial infection were age, days of hospitalization, diabetes, coma, hormones,,vascular catheter and ventilator.8.The infection site of the top three each year were lower respiratory tract, urinary tract and blood system. Lower respiratory infections constituted a ratio of47.43%, urinary tract infections constituted a ratio of15.44%; the blood system infection constituted the ratio of8.82%.9.The top five detected pathogens were Pseudomonas aeruginosa13.90%, Escherichia coli11.23%, Staphylococcus aureus9.63%, Candida albicans bacteria9.09%, and coagulase-negative staphylococci8.56%.10.The usage rate of antimicrobial drug was39.93%in2009years,36.79%in2010,35.41%in2011, and usage rate of antimicrobial were decreasing year by year. The total usage number of anti-bacteria drugs was2045, the total usage rate was37.30%. a joint usage was1474, constituted a ratio of72.75%, combination usage constituted a ratio of27.25%. The top ten departments of usage rate of antimicrobial drug were dept.of SICU87.50%, Respiratory78.21%,Urology74.48%, laminar flow ward73.68%, burn70.37%, Ophthalmology65.91%, oral64.71%,emergency57.14%, obstetrics and gynecology51.65%, the Anorectal50.85%and the ear,nose, Laryngology51.28%,and. The purpose of using the antibiotics in the dept. of Respiratory, layer flow ward was for therapeutic usage, the other eight sections were mainly for preventive usage. The top ten antibiotics were the third generation cephalosporin22.70%,the third generation cephalosporin/p-lact-masein hibitor9.67%,cephalosporin second generation8.29%, carbapenems5.03%, penicillin4.24%, cephamycin3.50%,anti-fungal3.26%, and the cephalosporin generation2.47%。Conclusions1.The nosocomial infection prevalence levels remained stable in2009-2011. The prevalence rate was roughly "U dimension in the distribution of age, The nosocomial infection prevalence was no statistically significance between male and female. The respiratory infections prevalence of male was higher than women, urinary tract infection prevalence of male was lower than females; The nosocomial infection prevalence of dept. of ICU, laminar flow ward, hematology was higher than the other divisions.2.The nosocomial infection prevalence increased with the extension of the duration of stay,. The nosocomial infection prevalence of surgical patients was higher than non-surgical patients.3.The univariate analysis showed that the risk factors associated with nosocomial infection were age, lengh of hospitalization, surgery, diabetes, coma, chemotherapy, hormonal, vascular catheter, urinary catheter, endotracheal intubation and ventilator. Non-conditional stepwise logistic regression model showed that the sixth risk factors associated with nosocomial infection were days of hospitalization, diabetes, coma, hormones,,vascular catheter and ventilator.4.The top three infection sites were lower respiratory tract, urinary tract and blood system.5.The common pathogens were Pseudomonas aeruginosa, followed by E. coli, Staphylococcus aureus. third generation cephalosporin was the top variety of antimicrobial drugs in inpatients, and we shoud strengthen the supervision and management of the rational use of antimicrobial agents. |
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