The Relationship Between Infection In Patients And Bacteriological Characterization In Ward In Neurological Department

Objective To analyze bacteriological characterization in air and bed unit of infectedpatients in neurological department and study the relationship of air and bed unit with infection in patients of neurological department.To provide theoretical basis for clinical sterilization and prevention of nosocomial infection in neurological departments.Data and MethodsFrom April 2009 to September 2010,110 infected patients of 2481 inpatients were collected from neurological department of Kailuan hospital. The ward consisted of 4 30m2 room(6 beds) and 5 18m2 room(2-3 beds). The samples were collected during 24 hours (9:00 to 10:00 in the morning) after infection when there was no movements and sterilization in ward. LWC-1 type centrifugal sampler were used for 1 minuter.Mediums was sealed immediately after sampling and were cultured in 35℃for 48 hours. then counted and identified.Colonies were smear and Gram stain to determine gram-positive bacteria,negative bacteria,to understand cell morphology,determine the bacteria,bacillus type.Bacterial inoculation needle points vertically using only the required sub-picked a single colony of pure bacteria.Another fixed point in the first area on the agar plate,Crossed with inoculating loop.After the first inoculation,inoculating loop area was burn,and then draw the second district followed by inoculation of three areas and four areas. Placed in 35°C incubator for 24 hours.Then Gram-positive,negative selection bacterial identification card. VITEK2 COMPACT automatic bacterial identification instrument was using for bacterial strain identification.The sample was collected from site of infection then cultured,pathogen species identification and susceptibility testing.Hospital infection surveillance methods was a prospective registration of survey methods. Database was set up using Excel 2003.Version 13 of SPSS was used for statistical analysis.Continuous variables are expressed as mean±SD and were compared by means of the t test or One-Way ANOVA. Discrete variables were compared with the use of theχ2 test.Correlate between variables was analysed using correlate and multiple regression.A significant P-value was defined as <0.05.Results1.There are significant differenties in the number of bacteria between summer,autumn,winter and spring(P<0.05),and the former is higher than the latter;ward bed flat pillows,quilts and environmental bacteriology quantity in different seasons has no significant difference (P>0.05). There are not significant differenties in the number of bacteria on ward bed flat pillows,quilts in different seasons(P>0.05).There are significant differences in bacteria between pillows of large ward and small one(P<0.05),and the former is higher than the latter significantly.There are not significant differences in numbers of bacteria in the air and quilts between large and small rooms(P>0.05).There are differenties in the number of bacteria between summer,winter and spring(P<0.05),and the former is higher than the latter.Simultaneously,differences also apperer between quilts and pillows in large and small wards(P<0.05),and the former is higher than the latter.2. The types of bacteria in the air environment in the hospital wards of nerve internal medicine department,the results demonstrates that Gram-positive coccus occupies 63.4%,and Gram-positive bacillus occupies 17%,Gram-negative bacillus occupies 4.9%,Gram-negative coccus occupies 0.86%,fungus occupies 13.83%.The bacteria of rates in the pillows in the hospital wards respectively are Gram-positive coccus occupies 68.14%,Gram-positive bacillus occupies 18.57%,Gram- bacillus occupies 2.73%,fungus occupies 10.56%.The bacteria in the cotton-wadded quilts'rates respectively are Gram-positive coccus occupies 67.05%,Gram-positive bacillus occupies 18.08%,Gram- negative bacillus occupies5.25%,Gram-negative coccus occupies 0.66%, fungus occupies 9.02%.The constitution of fungus'distribution in the air environment in the wards is higher than pillows and cotton-wadded quilts;the constitution of distribution in the nerve.Internal medicine department among Gram-positive cuccus,Gram-positive bacillus, Gram-negative cuccus,Gram-negative bacillus is without the differences.3. During the period of this study,2418 patients who are in the hospital wards are invested,110 infected patients;the spots that are infected are lower respiratory tract(73.29%),uninary tract(11.45%),Gastro-intestinal tract(2.29%).4. The results of monitor among infected pathogens:Gram-negative bacillus occupies 84%,pneumonia gram reber bacillus verdigris pseudomonad in main;fungus cooupies 3.67%,white rayon yeast etc in main.The sensitivity of Gram-positive coccus to eternal mildew element and so on is high,while the sensitivity of Gram-negative bacillus to South Metro Holdings Ltd is high,the sensitivity of fungus to Ketoconazo and Fluconazo is high.5. The number of bacteria in the air,pillows and cotton-wadded quilts in the hospital wards are obviously present related with the number of patients;the number of bacteria in the air is obviously inverse correlation with the areas of hospital wards;ther are no relations among the number of bacteria in pillows and cotton-wadded quilts and the areas of hospital wards,these three with the rate of months,month infection example time rate,the numbers of being out of hospital in different months have no obviously relations.There are no relationships between epidermis staphylococcus,Escherichia coli hopes the fungus,Acinetobacter baumannii and so on in the air,pillows and cotton-wadded quilts and the pathogen infected patients.Conclusions1. The number of bacteria were influenced by room size,patient number in ward and seasons.The bed unit was influenced by patient number in ward. Gram-positive cocci and Gram-positive bacillus were major,and few Gram-negative bacillus.2. The bacterial types in ward was assosiated with the ditribution of pathogens in the ward.They are important pathogens.There were no assosiation between infection and bacterial number.3. Accoding to size of room in ward,reasonal number of patients in the ward was important.To make more strickt survellance for indoor air and bed unit in neurological department and to stenthen enviroment sterilization are critical for protecting and controlling nosocomial infection.