Analysis Of The Characteristics And Trends Of Nosocomial Infection In A Respiratory Hospital In Nanchang From 2013 To 2017

Objective:This study retrospectively investigated the nosocomial infection case data of patients discharged from a respiratory hospital in Nanchang from 2013 to 2017,to understand the characteristics of the nosocomial infection and its distribution characteristics in this hospital.Based on the monthly incidence of nosocomial infections in the past five years,a time series model was established to predict the monthly incidence of nosocomial infections in 2018,and to understand the occurrence rules and trends of nosocomial infections.Methods:The nosocomial infection data and discharged patients database of a respiratory hospital in Nanchang from 2013 to 2017 were used to systematically describe the change of nosocomial infection incidence,as well as the distribution of nosocomial infection in population,department,site and pathogenic bacteria.Based on the monthly incidence of nosocomial infection from 2013 to 2017,the time series model was used to fit and predict the incidence of nosocomial infection.The monthly incidence of nosocomial infection in 2018 was used as the validation sample to evaluate the prediction effect of the model.Results:?1?From 2013 to 2017,a total of 79281 inpatients were monitored,among which 1596 nosocomial infections occurred in these years,and the average rate of nosocomial infection was 2.01%.The incidence of nosocomial infection decreased year by year,from 2.56%in 2013 to 1.63%in 2017??²=43.967,P<0.001?.The monthly incidence of nosocomial infection fluctuated regularly.The incidence of nosocomial infection was high in January,February,November and December,while it was relatively low from march to September.?2?In the cases of nosocomial infection,the youngest patients were 1 year old while the oldest one was 97 years old,and there was significantly difference in each age group of nosocomial infection??²=113.688,P<0.001?.Among them,the nosocomial infection rate was highest in the aged over 60 years old with the rate of2.55%,and it is lowest in the patients aged 15-44 of 1.28%.During the five years,a total of 54,536 male patients were discharged from the hospital,among which there were 1129 nosocomial infections with the rate of 2.07%.And there were 467nosocomial infections in the sum of 24745 female patients with the nosocomial infection of 1.89%.There was no significant difference in nosocomial infection between the two sexes??²=2.888,P=0.089?.?3?The average rate of nosocomial infection was high in ICU?27.95%?,followed by thoracic surgery department?4.39%?,neurology department?3.07%?and second thoracic surgery department?3.03%?,and other departments was below 2%.The nosocomial infection rate in neurology department decreased most significantly in 5 years??²=47.488,P<0.001?,from 5.21%in 2013 to 1.53%in 2017.And the respiratory department and cardiovascular department also decreased significantly??²=16.184,P<0.001;?²=10.786,P=0.001?.?4?The hospital infection site was mainly the lower respiratory tract?76.00%?,followed by the upper respiratory tract?7.58%?,urethra?4.64%?,surgical site?3.45%?,blood?2.69%?,pleural cavity?1.94%?.The constituent ratio of nosocomial infection sites did not change significantly in 5 years.?5?The pathogen of nosocomial infection was mainly Gram negative bacteria,accounting for 79.40%,followed by Gram positive bacteria of 14.79%and fungi of5.81%.The main pathogens of nosocomial infection were Acinetobacter,accounting for 29.90%in the total detected pathogens,followed by Klebsiella pneumoniae?15.12%?,pseudomonas aeruginosa?9.63%?,Escherichia coli?9.14%?and Staphylococcus aureus?6.48%?.?6?Time series analysis results show that ARIMA?0,1,1??0,1,1?₁₂2 model was the optimal model in which the AIC,SBC values were 34.008,37.708,and the MAPE value of its sample fitting was 14.12%,which is a good fit for the hospital infection.The incidence of nosocomial infection from January to December in 2018 was basically consistent with the predicted incidence with the MAPE value of 13.23%,which showed a better prediction effect.Conclusion:?1?The average rate of nosocomial infection was 2.01%,and it decreased year by year.January,February,November and December were high incidence periods of nosocomial infection.?2?The aged over 60 were the high-risk individuals in nosocomial infection,and there was no gender difference for nosocomial infection.?3?The departments with the highest nosocomial infection were ICU,neurology department and thoracic surgery department.The main site of nosocomial infection was the lower respiratory tract,followed by the upper respiratory tract,urethra,surgical site,blood and pleural cavity.?4?The pathogen of nosocomial infection was mainly Gram negative bacteria,and the main pathogens were Acinetobacter,Klebsiella pneumoniae,pseudomonas aeruginosa,Escherichia coli and Staphylococcus aureus.?5?ARIMA?0,1,1??0,1,1?₁₂2 model had a good prediction effect on the monthly incidence of nosocomial infection in 2018,which can provide a scientific basis for the prevention and control threshold of nosocomial infection.