| Objective:This study investigated a comprehensive tertiary hospital in Nanchang to analyze the prevalence of hospital infection at different stages of the COVID-19 epidemic;to investigate the influencing factors of hospital infection at different stages of the COVID-19 epidemic;and to propose hospital infection prevention and control measures for different stages of the epidemic.To provide data support and theoretical basis for the prevention and control of hospital infection,with a view to reducing the occurrence of hospital infection and its adverse consequences,and to provide reference for clinical work and enhancement of hospital infection management at similar hospitals.Methods:Basic clinical data of the patients were collected through consultation with clinicians,hospital staff and review of relevant literature,including patients’age,gender,whether they underwent surgery operation,use of antimicrobial drugs,frequency of hospitalizations and other data.Relevant data were entered and collated using Excel,and the data were statistically analysed and processed using SPSS22.0 and Origin2021 software.Single factor analysis was described by applying rates and composition ratios,and count data were analyzed by applying theχ~2test for trend and whether there was a statistical test of difference(test levelα=0.05).The application of Logistic Regression is a multivariate analysis method for studying the relationship between dichotomous or multicategorical observations and multiple influencing factors(independent variables).The relevant influencing factors were first examined with univariate analysis and those that have significant value(P<0.05)were selected for multi-factor logistic regression analysis.Cases were selected strictly according to diagnosis,inclusion and exclusion criteria,and patients from the same hospital were selected as control group to prevent information bias.Pre-surveys were conducted and problems identified were further modified.For incomplete or unclear medical histories in this study,telephone call-backs to patients were made for clarifying personal information.After checking and collating the input data,the data were entered into an Excel database to ensure that the data were authentic and reliable.Results:1.Hospital admissions increased year by year from 2019-2021,the number of hospital infection cases increased and the hospital infection rate continued to decrease(0.90%in 2019,0.67%in 2020 and 0.33%in 2021),with statistically significant differences(P<0.05).Hospital infection pathogenic test results showed a predominance of gram-negative bacteria,with respiratory tract infections and haematological system infections as the main sites of infection,and the main invasive operations were ventilator use,central venous cannulation and catheter cannulation.The high incidence of hospital-acquired infections was mainly in the intensive care unit(ICU),oncology and other surgical departments;the source of hospital-acquired specimens was mainly sputum and blood,and very few sterile hygiene samples failed.2.Multi-drug resistant organisms were predominantly Gram-negative in patients with hospital-acquired infections,and most of patients are elderly people.Single-factor and multi-factor Univariate multifactorial analysis of hospital-acquired infections showed that the number of hospitalizations OR=1.365(95%CI:1.025～1.816)and age OR=2.342(95%CI:1.331～4.120)in 2019(the period when the epidemic was not developing),2020(the period when the epidemic was developing)Number of hospitalizations OR=2.423(95%CI:1.800～3.261),age OR=2.501(95%CI:1.42～4.404),and in 2021(period of regular epidemic control)number of hospitalizations OR=1.650(95%CI:1.073～2.538),age OR=2.643(95%CI:1.217～5.739),the influencing factors of hospital-acquired infections remained unchanged and were all risk factors(OR>1),and the influencing factors changed in2021 were gender OR=1.192(95%CI:0.884～1.608),ventilator use OR=1.112(95%CI:0.478～2.586)and other related factors.Conclusions:1.The rate of hospital-acquired infections decreased from 2019 to 2021 at different stages of the epidemic development,with a statistically significant difference(P<0.05).According to single-factor and multi-factor logistics analysis,the factors influencing hospital infection remained broadly consistent across different periods of the epidemic,with gender,age,number of hospital admissions,antimicrobial drug use,ventilator use and other factors dominating the epidemic,and improvements in hospital infection prevention and control measures during the epidemic period,resulting in a smaller impact of the epidemic on hospital infection.Adjusting hospital infection prevention and control measures according to the development of the epidemic plays an important role in preventing and controlling the occurrence of hospital infections.2.Many of the factors that led to the MDRO outbreak during the COVID-19pandemic are modifiable.These mainly include adherence to PPE and hand hygiene,PPE shortages and antibiotic use.As healthcare professionals,we should not let our guard down and under no circumstances should we stop established infection prevention and control measures,as these remain the best tools at our disposal to prevent the spread of MDRO in our hospitals.The common pathogens are predominantly gram-negative bacteria,with no significant change.In addition,the implementation rate of hand hygiene and the use of antimicrobial drugs play an important role in hospital infections.3.To strengthen the surveillance of unexplained infectious diseases,improve the level of hospital infection protection,do a series of surveillance and early warning measures such as early detection,early isolation and early diagnosis,and develop corresponding preventive measures according to the three elements of infectious disease transmission(infectious source,transmission route and susceptible population)and the characteristics of each type of infectious disease. |
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