A Study On Evaluating And Analyzing The Nosocomial Infection Prevalence Of Surgical Patients In A Third-grade Class-A Hospital

Objective: To investigate the nosocomial infection prevalence and epidemiological characteristics of surgical patients by using retrospective investigation.Explores and analyzes the interdependent relationship of the risk factors and nosocomial infection and provide theoretical basis for preventing and controlling nosocomial infections.Methods: We collected the clinical data of 26,329 surgical patients form December 2015 to November 2017 in a Third-grade Class-A Hospital by by using retrospective investigation through manual work and information systems.The clinical data included the characteristics of patients,the situation of nosocomial infections,the risk factors of nosocomial infections.We register and classify the clinical data by using the Excel software.The risk factors were analyzed by Chi-squaretes,t test and Logistic regression model by using SPSS20.0.In the end,we described the epidemiological characteristics of nosocomial infection and analysis the risk factors.Results: 1.A total of 26,329 surgical patients had been investigated from 2015 to2017.There were 648 patients had nosocomial infection and the infection case accounted for 786,the infection rate was 2.46%,the infection case rate was 2.95%,the infection rate of neurosurgery was 13.11%.2.The top 4 nosocomial infection sites were in turn as follows:the lower respiratory tract infection in 374 cases(47.58%),the urinary tract infection in 163 cases(20.74%),the upper respiratory tract infection in 53 cases(6.74%),the surgical site infection in 45 cases(5.73%).3.There were 546 strains of pathogenic bacteria detected from the 648 patients of nosocomial infection.Among them,there were 399 strains of gram-negative bacteria,accounting for 73.08%,the first rank was Klebsiella pneumoniae,followed by Escherichia coli,Pseudomonas aeruginosa.One hundred and thirteen gram-positive bacteria had been isolated(20.76%),the first rank was Staphylococcus aureus,followed by Enterococcus faecium,Staphylococcus epidermidis.Thirty-four strains of fungus had been isolated(6.23%),mainly were Candida albicans.The result of drug sensitivity test showed that the resistant rate of pathogenic bacteria was high.4.The total number of patients who using antibiotics was 11,733,the usage rate of antibiotic was 44.56%.Of totally 11,733 patients who were used antibiotics,8335 were using single antibiotic,accounting for 71.04%,3134 were using two kind of antibiotics in the same time,accounting for 26.71% and 264 were using more than three antibiotics in the same time,accounting for 2.25%.5.Univariate analysis showed that the nosocomial infection of surgical patients was related to age,hospital stay,basic disease,operation,received urinary catheter,used the ventilator,received PICC(P<0.05),There was no statistical significance between patients gender(P>0.05).Multivarite logistic regression analysis showed that age over 60,hospital stay over 30 d,operation,received urinary catheter,used the ventilator,received PICC were independent risk factors for infection in the surgical patients.There were 11,256 patients who recieved surgical operation duration of hospital stay,accounting for 42.79%.Univariate analysis showed that the nosocomial infection of surgical patients undergoing surgical operation was related to hospitalization time before operation,the operation time(P<0.05).There was statistical significance between nosocomial infections of surgicall operation and index scores of risk factors(P<0.05).6.There were 953 surgical patients handled readmission,the rate of readmission was 3.62%,the first reason of readmission was malignancy,accounting for 65.37%.Univariate analysis showed that the nosocomial infection of surgical patients was related to patient readmission(P<0.05).Conclusion: 1.The nosocomial infection rate in neurosurgery hospitalized patients is high,we should pay more attention and take specific prevention strategies to reduce the incidence of nosocomial infection of neurosurgery.2.The main type of nosocomial infection sites were :the lower respiratory tract infection,the urinary tract infection,the upper respiratory tract infection,the surgical site infection.3.The resistant rate of pathogenic bacteria was high,we should have a reasonable ground for using antibiotics.4.The nosocomial infection of surgical patients was related to age,hospital stay,basic disease,operation,received urinary catheter,used the ventilator,received PICC.5.The nosocomial infection of surgical patients undergoing surgical operation was related to hospitalization time before operation,the operation time.6.The nosocomial infection of surgical patients was related to patient readmission.