A Retrospective Study Of Nosocomial Infection In A General Teaching Hospital In Southwest China From 2010 To 2015

1.BackgroundHospital infection(HI),also known as nosocomial infection,is an infectionthat is acquired in a hospital or other health care facility.The following situations do not belong to hospital infection:be hospitalized with infection and obtained infection out of hospital but occured in the hospital.According to the research object,the hospital infection can be divided into broad hospital infection and narrow hospital infection.The research object of narrow hospital infection is only the patient who in the hospital.Comparatively,the research object of broad hospital infection including the patient,the doctors,the nurses and everyone who come to hospital.The characteristics of hospital infection is rapid development,strong infectivity and high mortality rate.And the pathogenic bacteria are often drug-resistantly.Hospital infection is accompanied by the formation of the hospital,which is a serious threat to the health and life of patients,and has a significant impact on the quality of hospital care.It's not only prolong the hospitalization time,reduce the bed turnover rate,increase the cost of hospitalization,resulting in huge economic losses,but also hinder the development and application of new technology.At present,with the development of medical treatment,more and more departments have set up a special intensive care unit to treat critically ill patients.Due to the condition of critically ill patients,poor general condition,frequently use of antibiotics,more and more invasive operation,therefore,has become the hospital infection "disaster",seriously affecting the quality of medical care and life safety of patients.In the world,nearly one million people suffering from hospital infection every year.The foreign research shows that hospital infection caused by the extra expenditure of emergency care costs can be as high as $3.2 million thousand each year.Domestic research data also showed that: due to hospital infection,the direct economic losses caused to patients with an average of 3,4000 yuan per person,some diseases can be as high as 100 thousand yuan.Therefore,hospital infection has become the most serious public health problem,and also the most important issue in hospital management.And health management and hospital managers should pay attention to it.The study of hospital infection and management in our country is behind of the other country,especially to the western country.Because of the attention of health management departments,since 2001,the health departments and legal departments have issued a "diagnosis standard of hospital infection(Trial)","administrative punishment measures for medical waste management","hospital infection outbreak disposal report and management standard","hospital waste management measures","technical specifications","hospital hospital infection testing norms","hospital infection management measures",which means that the management is institutionalized and legalization and standardization of hospital infection.With the rapid development of medical and health technology,the seriousness and difficulty of hospital infection is becoming more and more prominent.2.AimThis study was based on a large general hospital from 2010 to 2015.To compare the different between normal patients and patients in ICU,medical patients and surgical patients,adult patients and children hospitalized patients,to provide more comprehensive hospital infection for the management of it,master the characteristics of hospital infection and trend,In order to effectively prevent and control the occurrence and development of nosocomial infection,and provide clinical evidence and reference for hospital infection management.3.MethodThis study is a retrospective study.Using the hospital infection detection system,fill out the questionnaire of hospital infection management: record the general condition of the patients(ID number,name,sex,age,date of admission,discharge date,duration of hospitalization,category of disease)and nosocomial infection(nosocomial infection,infection site,infection frequency,pathogen species,whether drug resistance),to analyze the different sections of the hospitalized patients with nosocomial infection.4.Results(1)During the period from 2010 to 2015,the nosocomiall infection rate in our hospital was 13.75%,the main pathogens were gram negative bacteria.And gram negative bacteria were mainly Bauman Acinetobacter,gram positive bacteria were Staphylococcus aureus,fungi was Candida albicans.(2)During the period from 2010 to 2015,the main pathogenic bacterium of ICU is gram negative bacteria and gram positive bacteria,according to different departments,the main site of infection,respiratory medicine is based on Bauman,Candida albicans and Pseudomonas aeruginosa,cardiovascular medicine in Bauman Acinetobacter,Candida albicans and Escherichia coli bacteria,neurology by Bauman Acinetobacter and Pseudomonas aeruginosa;the pathogens in surgical ICUmainlyGram-negative bacteria,emergency department by Bauman Acinetobacter,Klebsiella pneumoniae,Escherichia coli,department of neurosurgery in Bauman Acinetobacter,Klebsiella pneumoniae and Staphylococcus aureus,cardiovascular surgery is Klebsiella pneumoniae,Bauman Acinetobacter,Escherichia coli;(3)During the period from 2010 to 2015,the main pathogens of nosocomial infection in children were Klebsiella pneumoniae,Enterobacter cloacae and coagulase negative staphylococci,and the main pathogenic bacteria of adult inpatients were Acinetobacter baumannii,Pseudomonas aeruginosa,Candida albicans.(4)During the period from 2010 to 2015,the infection rate of most of the main pathogens of nosocomial infection has no obvious difference,but Bauman Acinetobacter,Pseudomonas aeruginosa as the representative of the pathogens has the upward trendin the colder seasons and lower air humidity fluctuates slightly,especially in the respiratory ICU.5.ConclusionFrom 2010 to 2015,The main pathogens of nosocomial infection in our hospital were gram negative bacteria.The main pathogenic bacteria in different departments are different.The main pathogenic bacteria of ICU were Acinetobacter baumannii,Pseudomonas aeruginosa and Candida albicans;as well,in the surgery ICU,the mainly pathogenic bacteria were Acinetobacter baumannii,Klebsiella pneumoniae,Escherichia coli.There are differences between hospitalized children and adult inpatients,Klebsiella pneumoniae,Enterobacter cloacae and coagulase negative Staphylococcus were the main pathogens in children,and the majority of the adults were Acinetobacter baumannii,Pseudomonas aeruginosa and Candida albica.