Research And Analysis On Nosocomial Infection Status In The Second Hospital Of Anhui Province

Objective To investigate and analyze the nosocomial infection(NI)status in 2013 and 2014 in the second hospital of Anhui Province,in order to provide reference for the control of hospital acquired infections and for the diagnosing and treating nosocomial infectiou cases.Methods All 954 inpatients with nosocomial infection hospitalized in 2013 and 2014 were investigated with retrospective survey method.The distribution characteristics of the section,the infection sites and pathogen were analyzed.The incidence rate in Intensive Care Unite(ICU)was the highest.Targeted surveillance of nosocomial infections was conducted in ICU.The distribution characteristics of nosocomial infections in ICU,especially the equipment related infections,were investigated.Results(1)Amonge all inpatients,of 34143 inpatients in 2013,406 developed 440 cases of nosocomial infection(NI),the incidence rate of NI was 1.19%,time-on incidence rate was 1.29%.As for 2014,of 36017 inpatients,548 developed 575 cases of NI,the incidence rate of nosocomial infection was 1.52%,time-on incidence rate was 1.60%.As for 2013 and 2014,the everage incidence rate of NI was 1.36%,the everage case-time prevalence rate was 1.45%.(2)The top four types of infection were pulmonary infections,upper respiratory tract infections,lower urinary tract infections and surgical site infections.(3)As for incidence rate,the top 5 departments were intensive care unite,department of hematology,department of neurosurgery,department of occupational disease,department of radiation oncology.(4)Pathogen test incubated 290 positive bacterial strains in total for 2013 and 2014.The proportion of Gram-negative bacilli was the most,accounting for 91.84% and 90.34% for 2013 and 2014 respectively.(5)Among pathogens isolated,the top 5 species were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Enterobacter cloacae.Antimicrobial susceptibility testing showed that multi-drug strains were identified in major 5 Gram-negative bacilli.According to the antimicrobial susceptibility testing,as for Escherichia coli and Acinetobacter baumannii,multi-drug resistant strains were identified over 70%.Carbapenems keep highest susceptibility in all antibiotics.(6)According to the analysis on the targeted surveillance of nosocomial infections(NI)in ICU,as for 2013 and 2014,the NI incidence rate of patients in ICU was 16.58% and 17.46% respectively.The daily NI incidence was 22.76‰ and 25.01‰ for 2013 and 2014 respectively.In 2013,the incidence of ventilator-associated pneumonia(VAP),central line-associated bloodstream infection(CLABSI)and catheter-associated urinary tract infection(CAUTI)was 33.28‰,2.77‰ and 2.27‰ patient-day respectively.The total of equipment related infections was 51,accounted for 62.2%.In 2014,the incidence of ventilator-associated pneumonia(VAP),central line-associated bloodstream infection(CLABSI)and catheter-associated urinary tract infection(CAUTI)was 62.56‰,0.86‰ and 1.15‰ patient-day respectively.The total of equipment related infections was 66,accounted for 73.33%.Conclusions(1)The incidence rate of the hospital acquired infections is low,in accord with the requirements of Ministry of Healthy.(2)As for incidence rate,the top 5 departments were intensive care unite,department of neurosurgery,department of hematology,department of radiation oncology,department of occupational disease.Inorder to control NI,surveillance on high risk departments,high risk patients and high risk factors should be strengthened.(3)The commonest pathogen was Gram-negative bacilli.Antimicrobial susceptibility testing showed that multi-drug strains were identified in major 5 Gram-negative bacilli.According to the Antimicrobial susceptibility testing,as for Escherichia coli and Acinetobacter baumannii,multi-drug resistant strains were identified over 70%.Carbapenems keep highest susceptibility in all antibiotics.(4)The targeted surveillance of nosocomial infections in ICU showed that,the daily NI incidence was 22.76‰ and 25.01‰ for 2013 and 2014 respectively.The total of equipment related infections was 51 and 66 in 2013 and 2014 respectively,occupied 62.2% and 73.33%.The key work to control nosocomial infections in ICU is to reduce equipment related infections.