Research And Analysis On Nosocomial Infection In Local Hospital

BackgroundAccording to the report，there were more than100thousand cases of NI and5000people dead each year in UK,which caused a direct economic loss of1.6billion euros;TheUnited States had over200thousand cases and2million people dead beacuse of NIoccured every year,and more than$4billion extra cost had been spent for curing NI.Thehospital infections cause additional mortality of4%~33%, the highest mortality ishospital acquired pneumonia.A research in Argentina shows that VAP, BSI (CA-BSI),UTI can increase the fatality rate of5%,25%,35%,respectively.The research showsthat,in developed countries, each NI cases can increase the cost of$1000to$4500(average$1800), and in the children’s ward (especially in NICU) the extra cost can reachmore than$10000.Nosocomial infections can not only aggravate a big burden forhospital staff, improve patients’ mortality, reduce sickbeds turnover rate, add the sufferingof patients, but also burden the patients’ and social economy.The significance obviously is there for the study of nosocomial infections,which ishelpful to prevent and control hospital acquired infections.I chose a local basic-levelhospital as the research object.Although the hospital is not very big,it has advancedmanagement concept and medical technology.In recent years,with the growth of amountof patients,the treatment level of success to the gravely ill and incurable disease has greatlyimproved.Methods Of Research1.Collection of data：Firstly,I searched and consulted all the inpatients cases duringJanuary2012to June2012,with the collection of patients’ basic information (age, gender,etc.), operation or not, use of medicine, length of hospital stay, discharge time, hospital acquired infections, pathogenic bacteria and drug sensitivity, etc.Secondly,looked througha large number of relevant literature.2.Separation and identification of pathogenic bacteria:According to MicrobialLaboratory Procedures,the clinical samples were cultured by automatic microbiologicalassay/drug sensitive test system which was produced by French Biological MerryAngstrom Company. The results were judged according to CLSI Standard,by using drugsensitive paper and board u produced by the UK OX Company. And used standard strainfor quality control at the same time. Quality control strains were pseudomonasaeruginosa ATCC27853, escherichia coliATCC25922and staphylococcus aureusATCC25913.3.Statistical analysis：Information was collected and typed into the EXCEL8.0,andwas analyzed by using SPSS17.0software.Results Of Research1. The infection rate was0.37%,daily infection rate was0.57%.2. The difference of nosocomial infection incidence of different age groups wasstatistically significant (P<0.01）.The infection rate of eldest groups(>90-year-old) wasthe highest, accounting for1.47%,while the young groups was the lowest，with the rate of0.14%.3. Different gender has different infection rate.The infection rate of male (0.65%) istwice higher than that of female(0.23%).4. The major infection sites were Urinary Tract infections accounted for49.1%,followed by the lower respiratory tract accounted for16.4%。Different age groups haddifferent sites of the hospital infection.5. The longer the length of hospital stay, the higher infection rate.Difference ofhospital stay had statistical significance (P <0.01).6. The highest incidence rate was in ICU1（4.20%），followed by ICU22.50％.Thatis why ICU should be the objective department of monitoring hospital acquired infections.7. There were3882cases of using antibiotics in12763patients, accounting for30.41%.The use of levofloxacin was the highest (863cases).8. The highest detection rate of bacteria was gram-negative aerobic bacteria(46.84%),gram-positive aerobic bacteria was23.06%,mycoplasma was22.75%, fungi was6.22%and anaerobic bacteria was1.13%.9. Susceptibility results showed that,in gram negative bacili, escherichia coli’ssensitivity rate to imipenem was98.9%,to cefotetan was97.5%.Tobramycin (96.93%) was the most sensitive antibiotics to pseudomonas aeruginosa, followed by amikacin(94.2%); Amikacin was the most sensitive antibiotics to acinetobacterbaumannii(80.59%),followed by tobramycin (54.8%). In gram-postive cocci,the sensitivityof staphylococcus aureus and staphylococcus epidermidis to vancomycin，linezolid，tigecycline and quinine was100%. The sensitivity of streptococcus pneumoniae tovancomycin is100%, followed by rifampicin (98.4%).Conclusions1. The nosocomial infection rate of this local hospital was relatively low.2. According to the rearch,age, length of hospital stay and gender all had influence onnosocomial infection rate. Along with the growth of age and the length of hospital stay,the infection rate is higher. Male patients had higher infection rate than the famale.3. ICU should be the objective department of monitoring hospital acquiredinfections.The major infection sites were urinary tract and respiratory tract.4. Gram-negative aerobic bacteria was the major pathogen of nosocomial infection,next is gram-positive aerobic bacteria. The antibiotic sensitivity of Multidrug-ResistantOrganism(MDRO) is generally low.5. The antibiotic use of this hospital was more normative,according to NosocomialInfections Management Standard.