Comparison Of Prevalence Of Nosocomial Infection Before And During COVID-19 Pandemic In A Tertiary Hospital In Liaoning

Objective:This paper analyzes and compares the occurrence and difference of nosocomial infections in a tertiary hospital before the COVID-19 epidemic(2018-2019)and during the COVID-19 epidemic(2020-2021),explores the possible impact of the prevention and control of the COVID-19 epidemic on the occurrence of nosocomial infections,and provides a basis for better formulating infection prevention and control measures and effectively preventing and controlling nosocomial infections.Methods:According to the"Diagnostic Standards for Hospital Infection(Trial)"issued by the Ministry of Health in 2001,four(twice a year)nosocomial infection prevalence surveys were conducted in a tertiary hospital in Liaoning Province using a cross-sectional survey method combining bedside survey and case investigation from 2020 to 2021,and data from four nosocomial infection prevalence surveys between 2018 and 2019 were collected.SPSS 22.0 software was used to statistically analyze the general situation of patients,the occurrence of nosocomial infection,the distribution of nosocomial infection sites,the use of antibacterial drugs,the delivery of pathogenic bacteria,the purpose and combination of antibiotics,the use of antibiotics and surgical site infections in different surgical incision types,the risk factors of nosocomial infection,invasive procedures,etc.,and the occurrence of nosocomial infections before and during the COVID-19 epidemic was compared and analyzed.The Chi-square test was used for the comparison of qualitative data,with P<0.05 as the statistically significant difference,and the statistically significant variables were selected for multivariate logistic regression analysis.A nonparametric rank sum test method is used for ordered categorical variables.Results:1.The total number of investigational cases in the eight nosocomial infection prevalence surveys from July 2018 to December 2021 was 10,434,and the total number of actual cases was 10,168,with a real detection rate of 97.45%.2.A total of 172 people had 192 nosocomial infections,and the prevalence rate of nosocomial infections was1.69%.The prevalence of nosocomial infections in the eight surveys ranged from 1.26%to 2.73%3.In terms of gender,the prevalence rate of nosocomial infection in male patients was 1.98%;The prevalence of nosocomial infections in female patients was1.37%.The prevalence of nosocomial infections in women was statistically significant compared with that in menX~2=5.71,P<0.05).4.The prevalence of nosocomial infections was lowest in the 20-29 age group,and the prevalence of nosocomial infections among inpatients aged 20 to 80 years and above generally increased with age.There were significant differences in the prevalence of nosocomial infections among different age groups(Z=-3.15,P<0.01).5.The top three departments with the current prevalence of nosocomial infections were intensive care units(11.88%),neurosurgery(6.89%)and radiotherapy(4.46%).6.The infection rates of surgical site in patients undergoing class I incision surgery,class II incision surgery and class III incision surgery were between 0.00%-4.23%,0.00%-0.79%and 0.00%-5.26%,respectively.7.The top three sites of nosocomial infections are the lower respiratory tract,upper respiratory tract and urinary tract.8.The antibiotic rate in the hospital ranged from 30.54%to 39.43%,and the specimen delivery rate ranged from 25.72%to 38.94%.The use of antibiotics in inpatients in this hospital is mainly monolithic,and the main purpose of use is treatment.9.The use rate of antibiotics in patients undergoing class I incision surgery,class II incision surgery and class III incision surgery was between 14.55%-59.42%,76.38%-99.06%and 33.33%-100.00%,respectively,and the proportion of antibiotics used for prevention generally showed a downward trend with the increase of surgical incision type level.10.Risk factors associated with nosocomial infections are gender,arteriovenous catheterization,urinary tract intubation,and ventilators.11.The prevalence of nosocomial infections before the pandemic(2018-2019)was 1.68%,and during the pandemic(2020-2021)was 1.71%,with no significant difference between the two groups(X~2=0.01,P=0.91).Compared with before the pandemic,there was no significant difference in the prevalence of nosocomial infection among inpatients aged less than or equal to 14 years,15 to 64 years old,and 65 years old or greater(X~2<0.01,P=0.93;X~2=0.91,P=0.34;X~2=0.88,P=0.35),there was no significant difference in the prevalence of nosocomial infection between male and female patients(X~2<0.77,P=0.38;X~2=0.94,P=0.33),receiving arteriovenous intubation(X~2=0.05,P=0.81),chemotherapy(X~2=0.62,P=0.43),ventilator(X~2=1.25,P=0.31),urinary tract intubation(X~2=1.12,P=0.29),surgery(X~2=0.26,P=0.61),there was no significant difference in the prevalence of nosocomial infection,and the use rate of antibiotics in hospitalized patients was increased significantly,and the difference was statistically significant(X~2=7.31,P<0.01).Conclusion:The average prevalence rate of nosocomial infection in this hospital is1.69%,which is lower than the average prevalence rate of nosocomial infection in China.The main risk factors for nosocomial infection in this hospital are gender,arteriovenous cannula,urinary tract intubation,and ventilators.There was no significant difference in the prevalence of nosocomial infections during the COVID-19 epidemic compared with before the COVID-19 epidemic,the antibiotic use rate of hospitalized patients during the COVID-19 epidemic was higher than before the COVID-19 epidemic,and there was no significant difference in the prevalence of hospital infections in patients who used arteriovenous intubation,urinary tract intubation,chemotherapy,ventilator,and surgery during the COVID-19 epidemic compared with before the pandemic.