The Cross-sectional Survey On Nosocomial Infection Of35Hospitals In Anhui Province In2012

Objective To describe the status of hospital infection in Anhui province, to discussand analyze the correlation of nosocomial infection with the risk factors, so as toprovide a certain basis for nosocomial infection control and reduction of the nosocomiall infection rate in Anhui province.Methods The stratified cluster sampling method was adopted for cluster sampling ofthe nosocomial infection monitoring network hospitals in Anhui province. The patientsin hospital on the day of November14,2012were taken as the research object,including the discharged patients on the day, but not including the hospitalized patientson the day. For the stratified step by step training survey content and method, firstly, theexperts of nosocomial infection quality control center in Anhui province conducted thesystematic training for the full-time workers of nosocomial infection managementsection, and then the full-time personnel conducted training for the clinical medicalpersonnel involved in the survey. The survey contents included the general informationof hospitalization, the hospital diagnosis, nosocomial infection sites, any omissions,pathogens, main pathogens of blood transmission, invasive operations, the use ofantibiotics, surgical incision and so on. The detailed record of information was enteredone by one into the professional software, skipped into EXEL file and then introducedto SPSS16.0for the statistical analysis. The count data was subject toχ2test, and theinfluence factors were subject to the single factor and multiple factors Logisticregression analysis.Results This survey should cover31943participants, but the actual survey covered 31656participants, with the real survey rate of99.10%. A total of769patients had804cases of nosocomial infection. The nosocomial infection rate of the patients was2.43%,with the case infection rate of2.54%. The top5of nosocomial infection sites were lowerrespiratory tract, upper respiratory tract, urinary tract, superficial incision and skin softtissue, with the proportion of46.39%,12.44%,9.70%,9.08%and6.84%, respectively.4.67%of the patients had HBsAg positive,0.76%of the patients had anti-HCV positive,0.29%of the patients had anti-HIV positive.7.52%of the patients adopted arteriovenousintubation,13.04%of the patients adopted urinary tract intubation,4.90%of the patientsadopted the ventilator and80.73%of the patients conducted intravenous infusion. Themale, intravenous infusion, arteriovenous intubation, urinary tract intubation, the use ofventilator and operation had relationship with the nosocomial infection, which were theindependent risk factors of the occurrence of nosocomial infection in hospital, with the Pvalues less than0.05. The surgical patients of11596people were surveyed, where4576people received surgical treatment, accounting for39.46%.2839people in patients withsurgical treatment used the antibacterial drugs before the surgery, accounting for62.04%.The antibacterial drug utilization rate of medical system was31.69%and theantibacterial drug utilization rate of surgical system was47.01%, where the differencewas statistically significant (P<0.05). The antibacterial drug utilization rate of ICU was79.64%and the antibacterial drug utilization rate of other departments was42.98%,where the difference was statistically significant (P<0.05). A total of500strains ofnosocomial infection pathogens were isolated, where pseudomonas aeruginosa was themost common (accounting for15.40%);6strains of methicillin-resistant staphylococcusaureus (MRSA) were detected, with the detection rate of14.63%.Conclusions This survey indicated that the nosocomial infection rate in Anhuiprovince was below the national level of nosocomial infection, where the male infectionrate was higher than women. ICU nosocomial infection rate was significantly higher than other departments, and its antimicrobial usage and invasive operation rate were higherthan other departments. A total of six risk factors such as male and invasive operationsrelated to the arteriovenous intubation, urinary tract intubation, the use of ventilator,intravenous infusion and surgery were closely related to the occurrence of nosocomialinfection. The antimicrobial usage conformed to the requirements of﹤50.0%by thehealth and family planning commission in our country. Both the clinical use ofantibacterial drugs and the empirical medication were common, and the consciousnessof specimen inspection was not high. The nosocomial infection pathogens were mostlyconditional pathogenic bacteria, the detection rate of MRSA was relatively higher.A lotof nosocomial infection related work need to do in the future.