Cross-sectional Investigation Of Infection In An Orthopedic Hospital In Zhengzhou From 2015 To 2020

ObjectivesThis study used the descriptive epidemiological methods to investigate and analyze the prevalence of nosocomial infections in an orthopedic hospital in Zhengzhou from 2015 to 2020.We aimed to find out the risk factors,to improve the prevention and treatment of nosocomial infections,and to put forward suggestions based on the comparison and analysis of the occurrence and development of nosocomial infections.Method:This paper used the data of the prevalence rate of nosocomial infection in an orthopedic hospital in Zhengzhou from 2015 to 2020.Each year,an orthopedic hospital in Zhengzhou participated in a national prevalence survey of nosocomial infection in accordance with the requirements of the National Hospital Infection Monitoring Center of the National Health Commission.The epidemiological survey of nosocomial infection from 2015 to 2020 was used to analyze the change of prevalence rate.On the survey day,the case questionnaire of nosocomial infection and the bedside questionnaire were required by the inpatients patients,which then summarized by the full-time staff of the hospital and entered into the ’national hospital infection cross-sectional survey data network processing system(2020 edition)’ processing,reporting,namely the Online Office System for nosocomial infection(http://oa.yygr.cn),)to participate in the cross-sectional survey of nosocomial infection in China.Software SPSS23.0 was utilized to analyze the data results.Descriptive analysis was conducted to describe the prevalence rate,according to the age,sex,the infection sites,and the occurrence of the corresponding departments.The χ2 test was used to compare the qualitative survey data,Bilateral test,test level α=0.05.Single factor analysis of influencing factors of hospital infection was carried out to filer the suitable variables,then the unconditional Logistic regression model was used to predictive model.Results:1.The prevalence rate of nosocomial infection patients from 2015 to 2020,a total of 8473 were investigated,106 people had nosocomial infection.Prevalence rate during 6 years of nosocomial infection was 1.3%.The highest prevalence rate of nosocomial infection was 2.81%in 2015,and the lowest was 0.5%in 2020.The prevalence rates of nosocomial infections in different years were compared,and the difference was statistically significant(x2=39.085,P<0.001).2.Comparison of the prevalence rate of nosocomial infection in different departments:The department with the top3 prevalence rate of nosocomial infection was ICU,which is 4.8%,trauma surgery of 3.5%,and Orthopedic surgery of 3.3%.3.The top three constituent ratios of different infection sites were:40 cases of surgical site infection,with a constituent ratio of 37.0%.The second was 16 cases of urinary tract and skin and soft tissue infections,accounting for 14.8%,and the third was 15 cases of other parts,accounting for 13.9%.4.The prevalence rate of nosocomial infection in different genders:the prevalence rate of nosocomial infection was 1.7%in male patients,is 0.7%in women.The prevalence rate in different gender was of statistically significance(χ2=14.360,P<0.01).5.The prevalence rate of hospital infections was different in different ages.this survey was according to their age,they are divided into of 0-14 years old group,15-64 years old group,and over 65 years old group.Among them,the prevalence rate was the highest in the over 65 years old group,which was 1.5%;followed by the 15-64 years old group with the rate of 1.3%;the lowest was among 0-14 years old group with only 0.3%.The prevalence rate of nosocomial infection in different age groups was different,and the difference was statistically significant(χ2=6.530,P<0.05).6.This survey Show 198 pathogens detected found 119 strains of Gram-positive bacteria,79 strains of gram negative bacilli.which showed Gram-positive bacteria were the main bacteria in an orthopedic hospital.Staphylococcus aureus was the most common Gram-positive bacteria,followed by Staphylococcus epidermidis.7.Utilization of antibiotics and submission rate of pathogens:The utilization rate of antibiotics decreased from 32.3%in 2015 to 31.5%in 2020.The difference of antibiotics utility was statistically significant(χ2=51.650,P<0.01).8.From 2015 to 2020,2293 cases were treated with one-drug combination,accounting for 94.25%of the total utilization rate of antibiotics,122 cases higher than that of two-drug combination,5%,11cases of three-drug combination,0.5%,and 7 cases of four-drug combination,0.3%.The combination of antibacterial drugs:one-drug therapy was most common.9.The risk factors screened out using Logistic for nosocomial infections were gender,antibacterial drug use,surgery,blood transfusion,tracheal intubation,indwelling urinary catheter,and length of stay in hospital.The OR value of gender(compared with reference)was less than 1,and the OR value of surgery(compared with reference)was less than 1,which was a protective factor.Antibiotic use(compared with reference group not used)OR=2.695,P=0.002,indwelling catheter(compared with reference group not used)OR=37.088,P=0.000,tracheal intubation(compared with reference group not used)OR=4.020,P=0.006,hospitalization days(compared with reference group less than 7 days)OR=1.019,P=0.049,blood transfusion(compared with reference group not used)OR=29.385,P=0.000,the above indicators OR values were greater than 1,can be seen as a risk factor for nosocomial infection.Conclusions:1.From 2015 to 2020,the prevalence rate of infection in the orthopedic hospital in Zhengzhou was decreasing.The highest prevalence of nosocomial infection was in the age group of over 65 years old.The prevalence rate of nosocomial infection in male patients was higher than that in the female patients.The prevalence rate of nosocomial infections in ICU ranks first.2.The top three constituent ratios of different infection sites are surgical site,urinary tract,skin and soft tissue,and other infection sites.The most common pathogens causing nosocomial infection were Staphylococcus aureus and Staphylococcus epidermidis.3.The risk factors of an orthopedic hospital in Zhengzhou are:the use of antibiotic,blood transfusion,tracheal intubation,indwelling catheter,ventilator,and the days of hospitalization.