The Investigation And Analysis On Nosocomial Infection In A Three Level General Hospital In Suzhou

Research backgroundHospital infection with the emergence of the hospital, and now has become the focus of the global medical community. Hospital infection is not only related to medical security, but also closely related to the occupational health of medical practitioners. More importantly, it greatly affects the quality of life and the quality of life of the people. Nowadays, the problem of hospital infection is widespread in many countries all over the world. Hospital infection in the patient’s life at the same time, but also cause serious economic losses. In recent years, the outbreak of hospital infection in the country, mass incidents, a serious threat to people’s health, but also to the hospital’s reputation, causing the doctor-patient relationship tension.Hospital infection monitoring is an important work to strengthen the management of hospital infection and prevent infection. The significance of monitoring of hospital infection is refers to:"for a long period of time, continuous system to collect the nosocomial infection, distribution, risk analysis, risk factors and send is the relevant departments to study, and for the nosocomial infection prevention and control work to provide a scientific basis for the to the hospital for the case surveillance and antimicrobial drug monitoring, disinfection and sterilization monitoring, hospital environment monitoring, and in the hospital and many other many aspects of monitoring. Through continuous monitoring of hospital infection time distribution, geographical distribution and the risk factors of hospital infection. Through the general regularity of the solution of hospital infection monitoring, including the incidence, susceptible population, vulnerable parts of infection, risk factors, disease, etc., so as to provide favorable support for the development of hospital infection managementIn recent years, with the application of interventional therapy, degree of population aging intensifies, antibacterial drug of a lot of abuse, and pathogen mutation and resistance, to the hospital infection prevention control caused by various effects, can not be taken lightly. At present, Staphylococcus aureus, tuberculosis, pneumococcal disease and so on, which produce resistance to many antibiotics, resistant to the increasing number of resistant Staphylococcus aureus strains, as well as multi drug resistant strains. The complexity and variety of nosocomial infection pathogens, which caused a serious impact on the management of hospital infection. At the same time, atypical pneumonia, Lyme disease, highly pathogenic avian flu, AIDS and other new infectious diseases continue to emerge, especially with the development of globalization, Ebola hemorrhagic fever, Marburg hemorrhagic fever, Rossini fever and yellow fever many in China had no exotic infectious disease also threatens the lives and health of people. Increasing management difficulty, the increasingly prominent problem of hospital infection, hospital infection management and professional and technical personnel put forward higher requirements.ObjectiveHospital infection causes great harm to the life and health of patients and medical staff. Therefore, it is necessary to strengthen the management and related medical personnel on the hospital infection, and only through the study of hospital infection, in order to grasp the relevant characteristics of infection, so as to take effective measures to prevent and control.This study through to 2013 to 2015 in Suzhou City of a tertiary general hospital infection survey to understand the characteristics of the hospital infection, hospital infection prevention and control provide the basis and reduce the incidence of hospital infection. The specific objectives of the study:(1) understanding inpatients with nosocomial infection status; (2) understanding of hospital infection department distribution, distribution of infection, infection pathogens and predisposing factors such as; (3) according to the research results, this paper puts forward some countermeasures and suggestions.Materials and methods1. Retrospective survey method was used to collect the relevant monitoring data of inpatients in a three level general hospital of Suzhou city from 2013 to 2015.2. According to "hospital infection diagnosis standard", make the diagnosis and fill out the "hospital infection case registration form", and send to the hospital infection management department.3. Data entry, finishing using Excel 2007 software. Based on the incidence of hospital rate, the Department incidence, susceptible location, distribution and drug resistance of the pathogenic bacteria, hospitalization time, operation and predisposing factors of comprehensive description and analysis.Results1.3 years a total of 153781 cases of patients were collected, the total number of 1230 people infected, the incidence rate of 0.80%. The incidence rates of 2013 to 2015 were 0.95%,0.77%, and 0.68%, respectively, and there was a significant decrease in the incidence of 3 years.2. The incidence of nosocomial infection in the top three of the departments were:ICU (20.61%), psychiatric (1.61%) and Department of internal medicine (0.84%). Which ranked in the top three in internal medicine department in order to Hematology (2.22%), Neurology (1.18%) and rehabilitation (1.10%), ranked in the top three in surgical departments in order to neurosurgery (1.31%), plastic surgery (1.12%) and bone (0.76%).3. In the first three parts, the main susceptible parts of hospital infection were lower respiratory tract infection (47.43%), upper respiratory tract infection (14.36%) and urinary tract infection (10.06%). Upper respiratory tract infection ranked the top five departments:Department of respiration (25.49%), Hematology (16.18%), cardiovascular department (15.20%), Neurology (14.22%) and psychiatrists (8.82%). Lower respiratory tract infection ranked the top five departments:ICU (46.59%), Neurology (9.64%) and emergency (9.05%), cardiovascular department (8.16%) and Oncology (6.53%). Urinary tract infection ranked in the top five departments:ICU (33.57%), Neurology (16.78%), rehabilitation (11.19%), neurosurgery (8.39%) and urinary surgery (8.39%).4. The main pathogens of nosocomial infection in the first several were: Bauman Acinetobacter (22.21%), Klebsiella pneumoniae (14.71%), Escherichia coli (12.21%) and Pseudomonas aeruginosa (12.02%). Bauman Acinetobacter infection in the first five of the infection site is:lower respiratory tract (82.25%), blood (7.36%), skin and soft tissue (3.46%), deep wound (2.16%) and urinary tract (1.30%). Klebsiella pneumoniae infection in the top five of the infection site is:lower respiratory tract (58.82%), blood (18.95%), urinary tract (8.50%), superficial wounds (6.54%) and skin and soft tissue (3.92%). Escherichia coli infection in the first five of the infection sites were:lower respiratory tract (34.65%), urinary tract (16.54%), superficial wound (15.75%), blood (14.96%) and deep wound (12.60%). Pseudomonas aeruginosa infection in the top five of the infection:lower respiratory tract infection (68.8%), skin and soft tissue (8.80%), blood (8%), superficial wound (6.40%) and urinary tract (4%).Pneumoniae, Klebsiella pneumoniae, Escherichia coli to beta lactam class, quinolones and aminoglycoside antibiotics have high drug resistance, the carbapenems (imipenem) olefin sensitive. Pseudomonas aeruginosa was highly resistant to the high resistance rate of Pseudomonas aeruginosa, and was sensitive to the fourth generation of the Acinetobacter bacillus of beta lactams, quinolone resistance serious, tobramycin, minocycline, compound new debbi Ming sensitive.5. The hospitalization time is less than 7d, the incidence of infection were 0.34% 14d and 14d hospital from 7 to 1.11% and 1.23%. ". In the fourth quarter, the highest incidence rate was (0.89%). ICU departments in the fourth quarter of the highest incidence of hospital flu (22.01%). The highest incidence rate of hospital infection in the first quarter (1.38%). The highest incidence rate of hospital infection in the first quarter (0.62%).6.There was a slight fluctuation in the incidence rate of hospital infection in t he four quarters, but there was no significant difference (X2=5.583,P>0.05).7.The hospital infection rate of 1.56% patients did not receive surgery, the hospital infection rate was 0.59%. The hospital infection rate in patients was significantly higher than that of untreated patients (P< 0.05).8. Hospital infection main factors row in front, followed by:surgery (14.77%), cancer (14.54%), radiotherapy and chemotherapy (13.12%), urinary tract intubation (12.78%), malnutrition (12.66%) and diabetes (11.7%).Conclusions and suggestionsConclusion1. From 2015 to 2013, the incidence rate of nosocomial infection in a class of three general hospitals in Suzhou was 0.80%.2. ICU, Department of Hematology, Kang Fuke, Department of Neurosurgery, Department of internal medicine, plastic surgery, Department of orthopedics and oncology department is the high incidence of hospital infection.3. Lower respiratory tract infection, upper respiratory tract infection, urinary tract infection is the key part of hospital infection. Department of respiration, Department of Hematology, cardiovascular department, psychiatric and neurological department of internal medicine is the high prevalence of upper respiratory tract infection. ICU, neural Department of internal medicine, emergency department, cardiovascular department and oncology department are the high incidence Department of lower respiratory tract infection. ICU, neurological department of internal medicine, Department of neurosurgery and Department of Urology, Department of rehabilitation is high prevalence of urinary tract infection.Pneumonia Klebsiella, large intestine angstrom Greek bacteria on beta acyl amine, cefquinome ketone, ammonia glycosyl glycosides antibiotics was with higher drug resistance and of carbon Penicillium alkene (sub amine culture south) sensitivity. Pseudomonas aeruginosa to beta lactams, carbapenem resistance rate is higher, the fourth generation cephalosporins (cefepime) and aminoglycosides sensitive. Bauman Acinetobacter serious of beta lactams, quinolone resistance, tobramycin, minocycline, cotrimoxazole and other sensitive.4. Klebsiella pneumoniae, Bauman Acinetobacter, Pseudomonas aeruginosa and Escherichia coli are the main bacteria causing nosocomial infections. Lower respiratory tract, blood, skin and soft tissue, deep wounds and urinary tract prone to Bauman Acinetobacter infection. The lower respiratory tract, blood, urinary tract, superficial wound and skin soft tissue were easily infected by Klebsiella pneumoniae. Escherichia coli infection in lower respiratory tract, urinary tract, superficial wound, blood and deep wound. Infection of lower respiratory tract infection, skin and soft tissue, blood, superficial wound and urinary tract are easy to occur.5. The incidence of hospital infection was increased with the length of hospital stay.6. The incidence of nosocomial infection in surgical patients was significantly higher than that in patients who did not receive surgery.7. Surgery, cancer, radiotherapy and chemotherapy, urinary tract intubation, malnutrition, and diabetes are easily hospital infection factors.Countermeasures and suggestionsIn view of the high incidence of hospital infection, the main susceptible parts, the main infection pathogens and the main predisposing factors, to take preventive measures to reduce the hospital infection.