ObjectiveTo investigate the incidence of nosocomial infection in acute and serious schizophrenic inpatients and its risk factors. MethodsBetween January 1st and December 31st, 2012, we investigated 1 621 schizophrenic patients on the status of nosocomial infections according to the hospital standard of nosocomial infection diagnosis. They were divided into infected group and uninfected group according to the survey results. The risk factors were analyzed by logistic regression method. ResultsTwenty-nine infected patients were found among the 1 621 patients, and the incidence rate was 1.79%. Among the nosocomial infections, the most common one was respiratory infection (79.31%), followed by gastrointestinal infection and urinary infection (6.90%). There were significant differences between the two groups of patients in age, hospital stay, positive and negative syndrome scale (PASS), combined somatopathy, the time of protective constraint, modified electraconvulsive therapy (MECT), using two or more antipsychotics drugs, using antibiotics and side effects of drugs (P<0.05). However, there were no statistical differences in gender, age classes, the course of disease, frequency of hospitalization and seasonal incidence of hospital infection (P>0.05). The results of multivariate analysis showed that hospital stay, positive symptom score, negative symptom score, the time of protective constraint, MECT, using two or more antipsychotics drugs and side effects of drugs were the main risk factors for nosocomial infection of inpatients with psychopathy (P<0.05). ConclusionBased on the different traits and treatments of acute and serious schizophrenia, a screening table of infections should be set. For the high risk group of nosocomial infection, effective measures should be taken to prevent and control the nosocomial infection of patients with schizophrenia.
ObjectiveTo learn the current situation and feature of nosocomial infection (NI), so as to provide reference for making the prevention measures. MethodsPrevalence rate of nosocomial infection in patients hospitalized on December 18, 2012 was investigated by the combination of bed-side examination and medical record checking. ResultsA total of 1 083 patients were surveyed, and the prevalence rate of nosocomial infection was 6.00%. Intensive Care Unit had the highest NI prevalence (28.57%), followed by Hematology Department (20.00%) and Neurosurgery Department (20.00%). Lower respiratory tract (38.46%) was the main infection site, followed by superficial surgical incision (13.85%). The usage rate of antimicrobial agents was 30.56%, and 40 strains of pathogens were isolated, in which Klebsiella pneumonia (15.0%), Pseudomonas aeruginosa (12.5%) and Escherichia coli (10.0%) were the main ones. ConclusionTarget monitoring management of key departments and key sites should be strengthened, and the management of antimicrobial agents should be stressed and invasive procedures should be decreased.
ObjectiveTo investigate the educational background of practitioners from the hospital infection control departments located in the mainland of China and reveal the necessity and employment prospects of setting up a major of hospital infection control for a bachelor degree in universities.MethodsA self-designed questionnaire was used to conduct an online survey on the Shanghai International Forum for Infection Control and Prevention and the WeChat group of nosocomial infection control from March 12th to March 25th, 2018. The convenient sampling method was used to investigate the leader of infection prevention and control department in each hospital. The survey included the regional distribution, attention on nosocomial infection control, existing staff structure, future staff needs and employment prospects of hospitals in 2018, and the attention on nosocomial infection control in the same period in 2014.ResultsA total of 1 654 questionnaires were obtained, from 30 provincial-level regions, including 103 maternal and child health hospitals, 143 other special hospitals, 258 hospitals of traditional Chinese medicine, and 1 150 general hospitals. Hospitals upgraded more attention on nosocomial infection control in 2018 than in 2014 [(3.76±0.98) vs. (2.94±1.14) points; t=-36.112, P<0.001]. Currently, there were 5 068.5 labors engaged in nosocomial infection control. The educational background of the current practitioners was mainly nursing [60.52% (3 067.5)]. In the next 5 years, 83.50% (820/982) of the hospitals that had recruitment plans planed to recruit graduates specialized in the hospital infection control, and respectively, 44.86% (742/1 654) and 17.35% (287/1 654) of the respondents believed that the employment prospects of graduates with bachelor degree specialized in the hospital infection control were good or very good.ConclusionThere is a tremendous demand for the graduates specialized in the hospital infection control, and it is imperative to set up this undergraduate major.
ObjectiveTo know the situation of nosocomial infection in 2014 in a western region hospital, in order to provide a scientific basis for hospital infection control and management. MethodWe selected the patients on August 14th in 2014 during the time from 00:00 to 24:00 as our study subjects. Bedside investigation and medical records investigation were combined to study the cross-sectional survey of nosocomial infection. We completed the questionnaire, and used statistical methods to count related data about nosocomial infections and community-acquired infections. ResultsA total of 1 908 patients were investigated. The nosocomial infection prevalence rate was 4.45%, and the community-acquired infection prevalence rate was 29.09%. The highest prevalence of nosocomial infection department was the Intensive Care Unit (38.10%); the top three surgical systems were Thoracic Surgery (18.67%), General Surgery (16.67%), and Neurosurgery (10.53%), and the top three medical systems were Endocrinology (11.11%), Neurology (6.67%), and Infectious Diseases Department (5.88%). The top three community-acquired infections occurred in Pediatrics Department (non-neonatal group) (95.37%), Burn surgery (92.31%), and Respiratory Medicine (86.46%). The main infection site for both nosocomial and community-acquired infection was lower respiratory tract (58.24%). Pathogens were mainly Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa. Hospital and community-acquired infection bacterial spectrum were consistent. And the rate of antibiotics use was 40.82%, in which 126 patients used for prevention (6.60%), and 599 patients used for treatment (31.39%). For patients using the drugs for treatment, bacterial culture submission rate was 80.71%, and the positive rate was 43.78%. ConclusionsThe prevalence of nosocomial infection is reliable, which provides a data support for nosocomial infection prevention and control.
Objective To understand the current situation of nosocomial infection management quality control centers at the municipal and county levels in Guizhou, so as to provide measures for promoting the construction of nosocomial infections management quality control centers at all levels in Guizhou. Methods From September 26th to October 12th 2023, based on the mobile network platform survey questionnaire of the infection prevention and control workshop, a survey was conducted on the establishment, personnel, information technology level, management, and quality control work of the nosocomial infection management quality control centers at the municipal and county levels in Guizhou. Results Nine prefecture-level cities/autonomous prefectures in Guizhou had established municipal-level nosocomial infection management quality control centers. The professional background of the staff at the municipal and county-level quality control centers was mainly nursing (accounting for 36.4% and 58.4%, respectively), and their educational background was mainly undergraduate (accounting for 70.5% and 83.3%, respectively). No quality control center at the municipal or county level had established an information-based quality control platform for nosocomial infection management within the region. Most county-level quality control centers did not have special funds (87.5%), and there were still 16 (25.0%) county-level quality control centers that had not established relevant systems for work and management. The main forms of quality control work carried out by each center were organizing training, on-site inspections, guidance and evaluation, and most of them were conducted irregularly. Conclusions Guizhou has basically formed a quality control system for nosocomial infection management at the provincial, municipal, and county levels. However, the nosocomial infection management quality control network has not fully covered all districts, and policies, funding support, and personnel allocation are still insufficient. Health administrative departments and quality control centers at all levels need to unify monitoring standards and quality control norms, strengthen supervision, improve quality control capabilities, and improve training systems to achieve standardization and normalization of quality control work throughout the province and improve quality control efficiency.
ObjectiveTo find out the major isolates distribution, drug resistance changes of multidrug-resistant organisms (MDRO) in 2013 for rational use of antibiotics and hospital infection control. MethodsA total of 32 566 cultured bacteria samples from the patients diagnosed between January 1st and December 31st 2013 were collected, using conventional tube biochemical assays and semi-automatic automicrobic (AMS) for bacteria identification; and antimicrobial susceptibility testing, major drug resistance mechanism detection were performed according to CLSI documents. MDRO definition was made according to the 2011 international consensus from European Center for Disease Control and Prevention (CDC), American CDC, Clinical and Laboratory Standards Institute (CLSI), and Food and Drug Administration. The data was analyzed by WHOnet 5.6 software. ResultsWe got 3 684 strains isolates, G- accounted for 76.08%, G+ 16.80%, fungi 7.11%, and fastidious bacteria 17.29%. The top ten isolates in order were:E.coli, A.baumannii, Ps.aeruginosa, H.influenzae, K.pneumoniae, S.aureus, S.pneumoniae, A.fumigatus, M.catarrhalis and C.freundii. From the first quarter 2012 to the fourth quarter 2013, the extended spectrum β lactamases (ESBL)-producing E.coli increased from 40.23% to 53.54%, ESBL-producing K.pneumonia increased from 14.28% to 34.78%, XDR-A.baumannii increased from 62.38% to 99.25%, metalloenzyme-producing Ps.aeruginosa increased from 7.37% to 25.37%, methicillin resistant staphylococcus aureus increased from 23.81% to 58.70%, and VRE increased from 0.00% to 28.12%. ConclusionIn the isolates, the percentage of G- was the highest, and the rate of MDRO are all unremittingly raising, which suggests us should pay more attention to microbiology analysis, rational use of antibiotics, strengthening hospital infection control, reducing the bacterial resistance, and strengthening MDRO surveillance.
Objective To compare the epidemic status of nosocomial infections (NIs) among medical institutions at different levels. Methods The cross-sectional surveys on prevalence rates of NIs, distribution of NIs, and antimicrobial use were conducted through combination of bedside investigation and medical record reviewing among all in-patients of 20 medical institutions in Baoshan District, Shanghai from 00:01 to 24:00 on November 12th 2014, December 9th 2015, and November 30th 2016, respectively. Results A total of 18 762 patients were investigated, the prevalence rate of NIs in the first, second, and third class hospitals were 5.36%, 2.37%, 1.68%, respectively (χ2=88.497, P<0.05). The main NIs sites were lower respiratory tract, urinary tract, and upper respiratory tract in the first and second grade hospitals; while were other unclassified sites, respiratory tract, and upper respiratory tract in the third grade hospitals. The utilization rates for antimicrobial in the first, second, and third grade hospitals were 5.88%, 31.64%, and 42.11%, respectively (χ2=928.148, P<0.05); submission rates for specimen were 9.82%, 48.89%, and 82.39%, respectively (χ2=601.347, P<0.05). Four cases of pathogen were reported in the first grade hospitals, 94 in the second grade hospitals, and 96 in the third grade hospitals. The in-patients in different hospitals with different genders, ages, and departments had a statistical difference in prevalence rate of NIs (P<0.05) . Conclusion The first grade hospitals need to enhance the etiological examination; the third grade hospitals should severely restrict the antimicrobial utilization, and refine the prevention and control work for NIs.
During the medical rescue after the Wenchuan earthquake, in order to prevent hospital environmental pollution and cross infection, the nosocomial infection control committee of West China Hospital of Sichuan University immediately initiated the emergency response plan, improved the triage system, and organized multi-disciplinary infection control groups to improve the triage of the wounded and the infection control of the emergency department. At the same time, we regulated the individual behavior of healthcare professionals and took appropriate measures for personnel protection so as to ensure the safety of both the wounded and healthcare professionals.
At present, the mode of day surgery has been widely carried out in China. With the rapid turnover of patients, higher requirements have been put forward for the management of nosocomial infection. Therefore, it needs norms for the management of nosocomial infection in the day surgery ward. After 10 years of precipitation, under the guidance of the hospital infection management department, the hospital infection management system for the day surgery ward of West China Hospital of Sichuan University has been continuously researched and explored, so as to ensure the rapid turnover of patients and make the hospital infection management meet the national standards. The system includes patient management and control, environmental management and control, matters needing attention of medical staff, surgical site infection data collection, and indicators of hospital infection supervision, etc.
Objective To investigate nosocomial non-fermented bacterial infection in lower respiratory tract and the risk factors for multi-drug resistant bacterial infection. Methods 229 patients with nosocomial nonfermented bacterial infection in lower respiratory tract from January to December in 2007 in Xiangya Hospital were analyzed retrospectively. The distribution and drug sensitivity of pathogens were recorded. Of those 229 patients,183 cases were infected by non-fermented multi-drug resistant bacteria( MDRB) . The risk factors for non-fermented MDRB infection in lower respiratory tract were analyzed by multi-factor logistic multiple regression analysis.Results The top four non-fermented bacteria isolated were Pseudomonas aeruginosa( 47.6%) , Acinetobacter baumannii( 36. 3% ) , Acinetobacter spp( 8. 6% ) , and Stenotrophomonas maltophilia( 5. 1%) . Higher isolatated rate was found in neurosurgery ( 25. 7% ) and central ICU( 22. 9% ) . The isolated non-fermented bacteria except Stenotrophomonas maltophilia were resistant to all antibiotics except cefoperazone-sulbactam and meropenem. ICU stay( P lt; 0. 001) , tracheotomy or tracheal intubation( P = 0. 001) , and previous use of carbapenemantibiotics( P =0. 032) were independent risk factors for non-fermented MDRB infection. Conclusion Non-fermented bacillus were important pathogens of nosocomial infection in lower respiratory tract with high rates of antibiotic resistance. It is important to prevent non-fermented MDRB infection by strict limitation on the indication of ICU stay,tracheotomy and use of carbapenem.