Cross Sectional Study Of Nosocomial Infection In Wuhan Area During 2010-2016

Objective:To describe the current situation of nosocomial infection in Wuhan area,and to provide clues for the prevention and control of nosocomial infection,based on the variation trend of cross-sectional survey results.Methods:Comparative analysis was conducted to handle the data collected from all hospitalized patients in the medical institutions that participated in a survey date in Wuhan area during 2010-2016.Results:The prevalence rate of nosocomial infection during 2010-2016 were 3.53%,3.00%,3.08%and 2.66%and,they were significantly different(P<0.001).The prevalence rate was gradually decreased from 2010 to 2016(Trend X2 test showed statistical significance,X2= 28.126,P<0.001.).Medical institutions with bed number<300 showed the lowest prevalence rate(2.13%,0.27%,0.00%and 2.64%in every survey)and it increased with bed numbers.The highest prevalence rate of nosocomial infection among departments was ICU(39.51%,26.29%,32.88%and 20.51%),followed by the department of hematology and neurosurgery.The prevalence rate of infection in department of hematology was declined in the four surveys as a whole.Lower respiratory tract infection accounted for the major part in the infection(50.84%,49.49%,48.53%and 47.45%),of which the prevalence rate decreased with the years.The results of the four surveys showed that the incidence of infection in different types of surgical incision was statistically significant(P<0.001).The higher grade of surgical incision type,the higher prevalence rate of nosocomial infection.The average utilization rate of antibiotics in the four surveys were 51.39%,39.87%,39.94%and 32.87%,and the difference was statistically significant(X2 =1909.769,P<0.001).The average utilization rate of antibiotics in the four surveys were statistically different(51.39%,39.87%,39.94%and 32.87%,X2=1637.854,P<0.001)and decreased with the years.There were significant differences in the pathogen detection rate(37.43%,52.04%,64.25%and 59.98%)which increased with the years.Not only the pathogen detection rate but also the utilization rate of antibiotics in medical institutions of different sizes was significantly different(P<0.001).The results of the four surveys showed that the average utilization rate of antibiotics in different types of surgical incision were statistically significant(P<0.001).With higher grade of surgical incision type,the utilization of preventive antibiotics was decreased and the utilization of therapeutic antibiotics was increased(Trend X2 test showed statistical significance,P<0.001).The utilization rate of one single drug alone is higher than the combination rate of two or three drugs.The results of pathogen monitoring showed that the main pathogenic bacteria are pseudomonas aeruginosa,acinetobacter baumanii,staphylococcus aureus,escherichia coli,klebsiella pneumoniae.Conclusions:The prevalence rate of infection has been decreasing and the control of infection has been good,overall.It is necessary to strengthen the control of ICU,lower respiratory tract and small hospitals infection to decline the infection rate on future.