Analysis Of Prevalenceand Influencing Factors Of Nosocomial Infection In A Hospital

Objective Through the data of nosocomial infection survey in a hospital in 2015, this research aimed at understanding the nosocomial infection’s present situation of general hospital, analyzing of the reason for hospital management, further improving the prevention of hospital infection and provide the basis for control. Methods The cross-sectional survey was adopted to collect data from all patients who were treated in hospital between 0:00 and 24:00 on March 9, May 14, August 18,November 4, 2015（Four quarters randomly selected a day）. On the basis of the cross-sectional survey case registration form of hospital infection in Hunan province, increased the influence factors of hospital infection.The survey was taken a method combined bedside one by one the survey with medical investigation, the nosocomial infection prevalence survey form filled out order by the bed. The diagnostic standards for nosocomial infection used in the survey are the same as those in "Diagnostic Standards of Nosocomial Infection（tentative）（ Health issue[2001]no.2）" issued by the Ministry of Health in January 2001. The four investigate was carried out in a unified method. The survey contents include the prevalence of nosocomial infection,the distribution of departments with nosocomial infection,the distribution of parts infected, the distribution of sex infected, the distribution of age infected, Invasive operation of hospital infection, the types of pathogens,the antibiotic usage,and so on.The qualitative data using the ? 2 distribution test. The criteria of statistically significant differences is p<0.05. Firstly, analysis the data by the univariate analysis, and then analysis the selected statistically significant variables statistically significant variables as independent variables, take the hospital infection or not as the dependent variable,Enter the unconditioned Logistic regression model（ ain=0.1,aout=0.05）,calculating the OR value. Results 1. The nosocomial infection investigation in 2015 should investigate 6584 people, in fact, investigate6519, the investigation rate was 99.01%,the infection number was 274,the infection prevalence was 4.20%. The difference between the four times survey was not statistically significance（?2=0.733,P=0.865）. 2.The top five depts of the hospital infection rates in 2015 were neurosurgery（37.14%）, ICU（36.51%）, pediatric（10.83%）, Blood oncology（9.2%）, neurology（6.85%）. 3. 10-year-old-age ^19.33%is the highest incidence rates,20-year-old-age ^2.57%is the lowest incidence rates. After 40-year-old-age group, The hospital infection prevalence rate increased with age. The difference of each age group was statistically significance（?2=594.12,P=0.00）. 4. The hospital infection is given priority to with respiratory tract infection（68.18%）, one of the upper respiratory tract was 22.73%, the lower respiratory tract was45.45%, followed by urinary tract infection（10.61%）. 5. The hospital infection rate with male was 4.97%, and the hospital infection rate with male was 3.09%. The difference between men and women were statistically significance（?2=13.82,P=0.00）. 6. In the 274 cases of hospital infection cases, the number of surgical patients was 53, the hospital infection rate was3.20%, the number of non-surgical patients was221, the prevalence rate was 4.55%, the difference was statistically significance（?2=5.59,P=0.02）. 7. The hospital infection prevalence of<8-day group was 2.96%, 4.03% of 8¹4days group, 5.02% of 15³0days group, 8.33% of >22 days group. The hospital infection prevalence rate increased with hospital stays. The difference of each day group was statistically significance（ ? 2=316.38, P=0.00）. 8. In 274 infections detected 97 strains pathogenic bacteria, mainly gram-negative bacteria（91.75%）,gram-positive bacteria（7.22%）, fungus（1.03%）; the top three pathogens of gram-negative bacteria were klebsiella pneumoniae（29.90%）, pseudomonas aeruginosa（25.77%）, acinetobacter baumannii（21.65%）;staphylococcus aureus have 5.15% in gram-positive bacteria. 9. The usage rate of antimicrobial drug was 49.64%; the joint usage was 79.57%,the Duplex medication usage was 19.68%,combination usage constituted a ratio of 0.74%;the treatment usage was76.58%, Prophylaxis was 13.04%, Treatment + preventive medicine usage was 10.38%;the topest departments of usage rate of antimicrobial drug were department of pediatrics, the rate were 100.00%, then the rate of antimicrobial drug was respiratory medicine（ 99.76%）. The preventive medicine proportion of thoracic surgical, dental, uropoiesis surgical department were higher, respectively 100.00%, 77.78%, 67.31%. The combination of antibacterial drug with obstetrics and gynecology,pediatrics, freshmen of pediatrics were higher, respectively 61.29%,58.75%, 50.91%. 3283 patients did not use of antimicrobial agents, there are 16 cases of hospital infection, hospital infection rate was 0.49%. The hospital infection rate with the patient use of a duplicate was 7.42%,combined was 30.14%, the joint and above was 79.17%. 10.The rate of pathogenic bacteria cultivation for inspection for use of antimicrobial agents was 43.38%, The highest Pathogenic bacteria cultivation rate was department of pediatrics（86.44%）, then was respiratory medicine（82.15%）, paediatrics（80.36%）. 11. Take the results of p<0.05 variables as the independent variable in the univariate analysis, take the hospital infection or not as the dependent variable, according to the stepwise method to carry out multi factor non conditional Logistic regression analysis, The independent variables into the regression equation have sex,Operation, hospital stay, use of ventilator, urinary tract intubation, arteriovenous intubation, tracheotomy, antibacterial drugs.Conclusions 1.The infection prevalence was 4.20%, the infection rates with men are higher than women, the respiratory tract infection rate of men was higher than women, the infection rate of neurosurgery,oncology, neurology, pediatrics, Hematology and Oncology were higher than others, the high incidence parts of hospital infection were respiratory tract and urinary tract, the most common nosocomial infection pathogens were pneumonia klebsiella bacteria, acinetobacter baumannii,pseudomonas aeruginosa. 2. The univariate analysis showed that the independent risk factors associated with hospital infection were Urinary tract intubation and tracheotomy, the use of breathing machine,arteriovenous intubation, use of antimicrobial agents,gender, length of hospital stay, age.