Investigation And Analysis On Nosocomial Infection And Distribution And Drug Sensitive With Pathogenic Of Inpatients In Local Hospital

Background and purposeNosocomial infections are infections which are results of treatment in thehospital.Infections are considered nosocomial if they occurred duringhospitalization oracquired in hospital but appeared after discharge, notincluding the infections existedbefore hospitalization. In addition, Hospitalstaff’s infections acquired in the hospitalare also considered as nosocomialinfections. Nosocomial infections have attractedmuch attention. InEngland, the hospital spend about ten million pounds per year in the studyof nosocomial infections, and the Centre for Disease Control and Prevention(CDC) of the United States has been on the constantprospective surveillance, monitoring of the development trend ofnosocomial infections and studying constantly on the issues identified fromthe survey. At the same time, the U.S. CDC puts forward procedures for theprevention and control of nosocomial infections, while also organizesthe implement. China in2001, the incidence rate of nosocomial infectionswas5.2%and4.8%in2003,4.8%in2005. Figures show that thecontrol of nosocomial infections in China has made great achievementsafter years of efforts. Nowmedical technology is undergoing rapidchange, at the same time,the complicated changes of thetransmission of nosocomial infections, susceptible populations and thepathogens have taken place. Therefore, the long-term surveillance ofnosocomial infection requires ongoing, in order to understand the trendand dynamic distribution of nosocomial infections accurately. The effectivepreventive measures are carried out after accessing to accurateinformation of nosocomial infections timely through surveillance, in order toprevent and control the incidence rate of nosocomial infections. Patients in different hospitals have different characteristics. This study is carriedout in a comprehensive local hospital, the main source of which iscommunity groups characterized by older. There will be less criticallyill patients and less difficult cases compared with the large hospital.Currently, community groups as the main source of outbreaks, theincidence of nosocomial infection are also a lack of systematic investigation.For this reason, this study aimed through the detailed investigation andanalysis on the hospital infections cases, pathogen distribution andantimicrobial spectrum of nosocomial infection in a local hospital ofShandong province from July2011to September2011to improve the overallawareness and understanding to the situation of nosocomial infections,provide a scientific proof for the prevention and treatment of infection andimprove health care quality.Methods1. Statistical methodsThe retrospective investigation carried out basing on the hospital’smedical records during2011.07-2011.09was carried out, with the collection of basic information, disease information, drug use, nosocomial infectiondiagnosis, pathogens and drug-sensitive case information of all hospitalpatients. The diagnosis of nosocomial infection based on the medicalrecords from doctors and the monitoring data from the hospital infectioncontrol Department. Moreover the incidence of hospital infection, diseaseposition, department distribution and the distribution of pathogenic bacteriawere analyzed by using SPSS13.0and EXCEL8.0.2. Isolation and identification of pathogensThe clinical samples were cultured according to Microbial LaboratoryProcedures, while bacterial identification and antimicrobial susceptibility testwere conducted using the United States MicroSan WalkAway40SI automatedmicrobial identification/susceptibility testing system and the KB method.The drug sensitive paper and board using in KB method were purchasedfrom OX Company, and the results were determined according to CLSIstandards. The quality control strains were using Escherichia coli ATCC25922,Staphylococcus aureus ATCC25913, Pseudomonas aeruginosa ATCC27853. ResultsThere were28cases of nosocomial infection among5228cases ofhospitalized patients from July2011to September2011. Through thestatistical research, the infection rate was0.54%; the major site was UrinaryTract infections accounted for81%, followed by the lower respiratory tractaccounted for18%; the incidence rate of disease of elderly groups were thehighest, respectively1.19%and1.03％; hospitalization time was longer as theincidence rate of nosocomial infections was higher. The incidence rate ofdepartments were the highest respectively4.57%and1.59％in intensive careunit. Most pathogens were gram-negative bacilli accounting for45.36%for504cases detection, E. yi’s bacteria (23.15%), Klebsiella pneumoniae (7.42%),Pseudomonas aeruginosa (7.30%) would be often found. At the same time,82Gram-positive bacteria strains were detected accounted for28.44%. Thecommon Gram-positive bacteria were Staphylococcus aureus (39.02%), Skinstaphylococcus(15.21%); streptococcus pneumoniae accounted for9.39%andfecal coliforms(6.47%）. Susceptibility results showed that Gram-negativebacteria to imipenem, Piperacillin sensitivity rate was more than90%,whilethesensitivity rate to Cephems was about50%; Gram-positive cocci to vancomycin sensitivity was100%. Currently vancomycin and linezolidresistant strains haven’t been found, ant the rate of staphylococcus aureussensitive to vancomycin was97.81%.ConclusionsIntensive care unit, cancer division and respiratory division, whichhospitalization time was longer and hospital infection rates and incidencedensity were higher, were the focal point monitoring objectives. Majorpathogens of nosocomial infections was Gram-negative bacteria, andclinical treatment should be based on the rational use of drug sensitivity test,to reduce fungal infections and drug resistance, in order to prevent andcontrol nosocomial infections effectively and shorter hospitalization timing.