| Objective To investigate the nosocomial infection prevalence rate, pathogenic microorganism, antimicrobial agents and diseases transferred by blood transfusion in a tertiary hospital, so as to provide the scientific basis for the prevention and control of nosocomial infection.Methods A cross-sectional survey method was used to investigate the nosocomial infection prevalence rate of four consecutive years (2010-2014) in a tertiary hospital, according to "Diagnosis Standard of Nosocomial Infection" enacted by the Ministry of Health of the People's Republic of China in Jan,2001. Surveys were conducted on one day each year in November according to the standards made by Anhui Center for Quality Control of nosocomial infection.Results In 2010-2014, on the annual survey day,5318 people out of the 5348 people that were supposed to be examined were actually examined. Thus the actual prevalence nosocomial infection survey rate was 99.44%, according with the requirement of Ministry of Health of the People's Republic of China which is 96%. Among all the surveyed subjects, male were 2791 and female were 2527; and 131 people,142 cases of nosocomial infection were found. ICU, neurosurgery department, department of thoracic surgery, blood group, department of orthopedics, Cardiovascular group, Digestion group, general surgery department, department of stomatology, other medical department, department of burn and tumor group had higher nosocomial infection rate, which were 25.00%,11.11%,10.91%,5.61%,5.51%,3.80%,3.43%,2.94%,2.86%, 2.53%,2.27% and 2.18% respectively. The nosocomial infection rate of hospitalized patients was 3.19%,2.32%,3.03%,2.34% and 1.74% from 2010 to 2014, respectively. The lower respiratory tract infection site was in the first place of each year, followed by urinary tract, upper respiratory tract infection, and the percentage were 36.64%,16.79%,10.69%,10.69% and 25.21%.91 plants(64.08%) of pathogenic microorganism were separated from the total 142 cases, with the top five being: escherichia coli-19 plants, pseudomonas aeruginosa 15-plants, baumanii-12 plants, fungus-9 plants and staphylococcus aureus-5 plants. For 5 consecutive years, the antibiotic using rate were 48.88%,40.04%,37.59%,36.85% and 36.23% respectively. The rates of the therapeutic use of antimicrobial drugs were 44.35%, 55.07%,60.52%,57.98% and 62.23%respectively.Whenthe purposes of the therapeutic use of antimicrobial drugs were divided into prevention, treatment, prevention and treatment, their constituting rates were 36.48%,55.77% and 7.75%respectively. The rates of the exclusive use,2 joint use,3 joint use,4 and more than 4 joint use of antimicrobial drugs were 72.82%,26.22%,0.67% and 0.29%respectively. Among all the patients in hospital,5.10% were HBsAg positive,0.62% were anti-HCV and 0.08% were anti-HIV.Conclusion The nosocomial infection rate of the consecutive five-year in the hospital was controlled less than 10% as required by the Nosocomial Infection Administrative Measures, and the rate of anti-biotics is in the target range. The key and difficult point of the nosocomial infection supervisory work is the pathogenic microorganism separated from the nosocomial infection cases, especially the multiple resistant bacteria such as extended-spectrum?-lactamases escherichia coli, pan-drug resistant acinetobacter and methicillin-resistant staphylococcus aureus. The department with high incidence of nosocomial infection department should be taken as the target of control management. Medical workers in these departments especially the new comers should be trained and assessed on nosocomial infection. When they perform operations, they should strictly abide by the aseptic technique and the regulations. They also should wash their hands correctly and carefully before operations, change medicine and nursing of patients. And in order to reduce the chances of nosocomial infection, they should pay attention to the management of the wash, disinfection, sterilization and store of the medical instrument that will be repeatedly used. |
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