Surveillance On Nosocomial Infection Of Operative Patients In A Hospital

ObjectivesThe aim of this study is to analyze the operative in-patients in prospective nestedcase-control study;the study explores the risk factors of nosocomial infection in operativein-patients using targeted surveillance;nosocomial infection uses incidence,incidencedensity,case-time incidence and other indicators in operative in-patients.Nosocomialinfection surveillance can provide reference for hospital authorities,so some effectivemeasures can control and prevent nosocomial infections.Nosocomial infectionsurveillance also lays the foundation for hospital to deal with public health emergencies.MethodsThe study collects operative in-patients in a hospital during1January2013to31December2013.They must be in hospital more than48hours of operative in-patients.They consist of the corresponding queue.The nature outcome occurs nosocomialinfection,leave hospital or death.We observe those operative in-patients.If the operativein-patients occur nosocomial infection,they entered in the case group of nosocomialinfection.By contrast to the other operative in-patients bring into control group.Weexplore the correlation between nosocomial infection and risk factors.Results1There are219cases nosocomial infections.The control group included3585 non-nosocomial infections of operative in-patients.The incidence was5.8%.Theincidence density was6.7‰.False negative rate was12.7%.2The primary type of nosocomial infection is respiratory infection in operativein-patients.3Logistic regression analysis showed:the male’s incidence of nosocomial infectionwas higher than female’s; the in-patients whose age was between14and60have thelowest incidence of nosocomial infection;the in-patients older than60aged have thehighest incidence of nosocomial infection;the precaution use of antibiotics can reduce theincidence of nosocomial infection before surgery;the in-patients whose are in hospital oftime shorter before surgery is low incident;the more time of surgery duration,the higherincident is occur;the incidence of nosocomial infection of elective operative patient islower than that of emergency operative;the incidence of nosocomial infection of generalanesthesia is higher than these of other anesthetic methods;invasion operations andincision type are risk factors of nosocomial infection.4The results of this study showed that the average risk factor index of all operativein-patients is1.7. Thoracic surgery is the highest risk factor index.Obstetric department isthe lowest risk factor index.5After adjusted for risk factors index, the sort of nosocomial infection incidencevaries with the previous.General surgery standardized sorting declined.Obstetricsdepartment standardized sorting increased.6This study showed that surgery was still surgery prophylactic use of antibioticsprophylaxis.Time of preventive medication exists unreasonable phenomenon.7Common nosocomial infection pathogens were gram-negative bacteria in surgicalpatients, followed by gram-positive bacteria.The main pathogenic microorganisms:escherichia coli, pseudomonas aeruginosa, acinetobacter spp.8The median value of medical expenses19,897.1RMB on the case group,themedian value of medical expenses6,584.6RMB on the control group, medical expenses of the case group was significantly higher the control group.Conclusions1This study found that the main type of nosocomial infection is respiratory infectionsin surgical in-patients using prospective case-control study.If respiratory infections can beeffectively controlled,the incidence of nosocomial infection will reduce.2The study shows that independent risk factors of nosocomial infection for operativein-patients were male in-patients,patients over60years old,un-precaution usingantimicrobial drugs,hospital stays more than three days before surgery,emergencyoperation,anesthesia,surgery duration greater more than2hours, incision type,invasivesurgical operation.3The study described nosocomial infection using incident,incident density and riskfactors index.This method is more scientific.4This study observed operative in-patients using a prospective nested case-controlstudy.This study can accurately estimate the incidence of nosocomial infection intensity.