| Objective:We intent to analyze the hazard factors resulted in hospital infection, achieve its characteristics and tendency via the investigation to the infection situation in a general hospital, in order to make a suggestion to control the infection. The quality of medical care will improved with the decrease of hospital infection, which leads to economic losses and extend of hospital stays.Method:We selected a sample from medical cases of discharged patients in a general hospital in2012. All data were collected from Questionnaire of Hospital Infection in Hospital Information System(HIS) system. The dataset was consisted of general situations and hospital infection situation. The former included identification number (ID), name, gender, age, marital status, data of admission, data of discharge, length of stay, chronic foundation disease, use of immunosuppressant, invasive operation,whether in resuscitating room orintensive care unit (ICU), use of antibiotics, whether transferred to another hospital, etc. The latter included whether existed hospital infections, frequency, name, infection site, pathogenic-bacteria, drug fastness, etc. The dataset was established by EXCEL, analyzed by SPSS17.0.Result:1. We collected45368medical cases for leaving hospital from1/1/2012to12/31/2012,699of which were hospital infections, and the infect rate was1.54%. There were802hospital infection cases, and the rate was1.77%. Among the23335female patients,260(1.11%) suffered infections. And among the22033male Patients,439(1.99%) suffered infections. This part was statistical significant (x2=57.623, P<0.001).2. The investigation included patients aged from2hours to98years old. Considering the influence of age, patients younger than1year old had the highest infection rate, which was18.14%. On contrast, the patients aged～1year old had the lowest infection rate, which was only0.06%. This part was statistical significant (x2=516.345, P<0.001).3. Considering the marital status, the infection rate of married people was1.81%, unmarried was0.63%, divorced was0%,widow and widower was3.91%. This part was statistical significant (X2=103.128, P<0.001).4. Considering the data for admission, patients admitted from Apr. to Jun. had the highest infection rate (1.81%), and patients admitted from Oct. to Dec. had the lowest rate (1.22%). There was statistical significance among the four groups (X2=13.332, P=0.004).5. Considering the length of stay, the rate of hospital infection increased with the extend of stay. Patients staying for more than one month were most suspectible, which was31.31%(201/642). There was significant difference between patients staying in diverse length. Most patients (29.76%) suffered infection after the first week in hospital.6. There was the highest infection rate in department of Integrated ICU, of hematology, and of cardiac surgery. The lowest existed in the department of stomatology, dermatology and ophthalmonogy. Department of ICU, hematology and nephrologyhad the highest infection rate among departments of internal medicine. Department of cardiac surgery, brain surgery, and spare-part surgery had the highest infection rate among departments of surgery.7. Lower respiratory tract, blood and urinary system are most susceptible to infection.8. Among all the chronic foundation diseases, patients with circulatory system diseases are most susceptible, followed by digestive systemdiseases and respiratory system diseases.9. The risk factors associated with nosocomial infection were age, diabetes, cancer, immunosuppressor, hematopathy, and vascular catheter, urinary catheter, endotracheal intubation and ventilator were the most influential invasive operations.10. Most of pathogenic microorganism were Gram+bacteria (70.15%), including Klebsiella pneumoniae, pseudomonas aeruginosa, Escherichia coli, followed by Gram-bacteria, including Staphylococcus aureus (with MRSA), Enterococcus faecium (with VRE), staphylococcus epidermidis. Least pathogenic microorganism were Fungi (9.57%).11.26.18%of the infected patients took one kind of antibiotics,26.90%used two kinds of antibiotics, and18.88%of them chose three kinds of antibiotics.26.32%of them used four or more than four kinds of antibiotics.12. On the aspect of disease outcome, nosocomial infection rate of death patients is the highest (4.39%),the difference of incidence of hospital-acquired among groups was significant byx2-test(x2=137.573, P<0.001).Conclusion:This study implied that in2012the hospital infection in this hosPital was1.54%, which was lower than the demand of Hospital Infection Management Regulation established by Department of Health. In this rule, hospitals with more than500beds are demanded to limit the infection rate under10%. According to our study, male patients had a higher infection rate than female. Infection rate increased with age. It was also related to chronic foundation diseases, intrusive operation, length of stay and antibiotics. On the aspect of disease outcome, nosocomial infection rate of death patients is the highest,which tips nosocomial infections are a leading cause of in-hospital mortality rate increased risk factors.In summary, hospitals are suggested to paying attention to set regulations and investigation of infection, and take measures to decrease the infection rate. |
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