Study On The Nosocomial Infection Status Of Hospitalized Patients In A Tertiary Teaching Hospital

BackgroundWith the progress of medical technology and the development of modern hospital,the change of the disease, a new pathogens appearing constantly, severe multiple drug-resistant bacteria infection, and the constant improvement of the degree of population aging, all makes the hospital infection problem increasingly prominent and complex.The prevention and control of hospital infection has become the major challenges facing today’s medical community, as an important index of hospital quality management system by the world health organization (WHO).ObjectiveThis study is built on the tertiary teaching hospital2013hospitalized patients with hospital infection status survey and understanding its key crowd, key section office of hospital infection, infection of the main parts and the features of the composition of infection pathogens, analysis of related factors of hospital infection.All the above can help hospital managers to further providing the reference for the prevention and doing the control work of hospital infection well.It can also reduce hospital infection and avoid nosocomial infection’s outbreak. So we can improve the quality of hospital medical treatment and achieve the purpose of the patients’medical security.Materials and methods1.Take active reported clinical physicians and hospital infection professionals retrospective investigation combined with prospective investigation method.And collect hospitalized patients in the hospital infection from the tertiary class-B teaching hospital on January1,2013-to December31,2013.2.Diagnose the case of infection on the basis of the professional committee’s The Standard of Hospital Infection.3.Use the Excel and SPSS13.0software for data entry, arrangement and statistical analysis.Analyse the nosocomial infection pathogens on the age, sex, section office of hospital infection distribution, hospital infection risk descriptively.Main results1. The hospitalized patients with hospital infection rate is1.11%;Hospitalized patients with hospital infection cases’rate is1.15%.2. The top five incidence rate in nosocomial infection is:comprehensive ICU and neurosurgery, onset, renal medicine, oncology, infection rate is respectively:57.14%,6.61%,3.33%,3.03%,2.33%.3.The hospital infection rates of infected people is "U" type distribution along with the age growth.0～3years old group of children with hospital infection rate was lower than those of infection after age40age groups, but higher than4～39hospital infection rate in every age group;The adult group’rate increases with the growth of age.By comparison, patients with hospital infection rate among all age groups are not the same or not all the same, difference was statistically significant (χ2=384.268, P=0.000).4. The male patients with hospital infection rate was1.28%and the female patients was1.00%, upon χ2examination. The difference was statistically significant (χ2=8.136, P=0.001).Male patients with upper respiratory tract infection (0.37%) was more than women (0.20%)and the difference was statistically significant (χ2=11.678, P=0.001).Male patients with lower respiratory tract infection (0.61%) was more than women (0.30%) and the difference was statistically significant (χ2=24.214, P=0.000).Female patients with urinary tract infection (0.25%)was more than men (0.12%) and the difference was statistically significant (χ2=10.473, P=0.001).Female patients with gastrointestinal tract infection rate (0.09%)was more than men (0.05%) and there was no statistically significant difference (χ2=2.811,P=0.094).5. Patients in the hospital for a week (<8days) cases of infection rate is lowest--0.59%.More than a month in hospital (31days～) cases of infection rate is highest--5.26%.From October toDecember,the infection rates are highest. Hospital infection rate is associated with season increasing wih the longer duration of hospitalization.6. Surgery patients with hospital infection rate (1.58%) was more than not surgery patients with hospital infection rate (1.01%).The difference was statistically significant (χ2=23.885, P=0.000).7. Hospital infection site in the top three was in the order:lower respiratory tract, upper respiratory tract and urinary tract.The constituent ratio is respectively,40.45%,25.47%,16.10%.8.A total of372strains pathogenic bacteria has benn isolated from nosocomial infection pathogens, top five pathogenic bacteria in the order:75strains of e. coli (20.16%), pneumonia klebsiella bacteria57strains (15.32%), pseudomonas aeruginosa,359.41%,20strains of staphylococcus aureus strains (5.38%),15strains of acinetobacter baumannii (4.03%).9. Multi-resistant bacteria nosocomial infection is the main pathogenic bacteria. And specimens mainly comes from the lower respiratory tract, urinary tract, secretions, blood.Conlusion and advice1. The hospital infection rates are consistent with the provisions in the Hospital Infection Management Method--the hospital nosocomial infection incidence of more than500beds should be less than10%. 2. The elderly and infants are the focus of the crowd.They should be payed special attention to strengthen infection prevention of these two types of people.3. Corresponding prevention and control measures should be taken through the combination of ICU, neurosurgery, and blood internal medicine department of the hospital infection incidence, according to the characteristics of the different departments of the hospital infection4. The occurrence of hospital infection may be associated with season.The hospitals are adviced that they should strengthen the environmental management during the winter in order to strengthen the management of air purification and improve air quality and reduce hospital infection occurred.5. Gender, length of hospital stay, and surgery is related factors of hospital infection.The corresponding prevention and control measures of hospital infection should be adopted according to different factors.6. Lower respiratory tract, upper respiratory tract, gastrointestinal tract and urinary tract are key parts of the hospital hospital infection, so these cases should particularly be strengthen for the purpose of the hospital infection prevention and control of this a few parts.7. Building multi-resistant bacteria is the main pathogenic bacteria, the hospital infection should be attached great importance to hospital infection by controlling multiple drug-resistant bacteria.