ObjectiveTo understand the characteristics of and risk factors for nosocomial infection in a newly built branch of a university teaching hospital, in order to investigate the control measures for prevention and control of nosocomial infection. MethodsA total of 598 cases of nosocomial infection from April 2012 to June 2014 were enrolled in this study. We analyzed statistically such indexes as nosocomial infection rate, infection site, pathogen detection, and use of antibiotics. Meantime, infection point-prevalence survey was introduced by means of medical record checking and bedside visiting. ResultsAmong all the 44 085 discharged patients between April 2012 and June 2014, there were 598 cases of nosocomial infection with an infection rate of 1.36%. Departments with a high nosocomial infection rate included Intensive Care Unit (ICU) (9.79%), Department of Orthopedics (2.98%), Department of Geriatrics (2.62%), and Department of Hematology (1.64%). The top four nosocomial infection sites were lower respiratory tract (45.32%), urinary tract (13.21%), operative incision (8.86%), and blood stream (8.86%). The samples of 570 nosocomial infections were delivered for examination with a sample-delivering rate of 95.32%. The most common pathogens were acinetobacter Baumanii (17.02%), Klebsiella pneumoniae (14.21%), Escherichia coli (13.68%), Pseudomonas aeruginosa (11.93%), and Staphylococcus aureus (9.12%). And urinary tract intubation (42.81%), admission of ICU (28.60%), and application of corticosteroid and immunosuppressive agents (26.42%) were the top three independent risk factors for nosocomial infection. ConclusionGeneral and comprehensive monitoring is an effective method for the hospital to detect high-risk departments, factors and patients for nosocomial infection, providing a theoretical basis for prevention and control of nosocomial infection.
目的 了解醫院感染現患率及危險因素，及時調整醫院感染預防控制措施。 方法 醫院感染管理專職人員與臨床醫師共同調查2010年12月15日0：00～24：00所有住院患者，查閱病歷和床旁調查相結合，填寫統一的現患率調查個案登記表和床旁調查表，對調查結果進行統計分析。 結果 醫院感染現患率2.49%；科室主要分布在綜合重癥監護病房（ICU）和內三科（腫瘤和內分泌專業）；部位主要分布在下呼吸道、泌尿道、血液；導管相關感染有增加趨勢，不合理使用抗菌藥物問題較突出。 結論 綜合ICU和內三科是新津縣人民醫院的重點科室；下呼吸道、泌尿道、中心靜脈置管部位是重點部位；侵襲類操作及不合理使用抗菌藥物是危險因素；該院醫院感染預防控制工作重點：加強導管相關感染監測，增加耐藥菌監測，加強對綜合ICU、內三科的管理，加強對侵襲性操作及合理使用抗菌藥物的管理，提高病原學送檢率。
Objective To evaluate the effects of mass immunization campaign on the epidemiological characteristics of measles. Methods Comparison was made between the incidences of measles before and after the mass immunization campaign in 2007 in Shunqing prefecture of Nanchong city. Results The total number of the reported measles cases reached 460 during 2004 to 2007 in Shunqing prefecture of Nanchong city, and the respective annual rates of incidence were 4.04, 23.53, 11.84, and 33.57, respectively per 100 000 heads. Cases reported from April to July accounted to 73.91% of the total (340/460). Children under 15 were reported to have the highest incidence rate and accounted to 83.70% of the total (385/460), of which incidences of children under 1 accounted to 0%, 10.81%, 13.51% and 25.82%, respectively. Only 20.00% of the subjects (92/460) in this study had a definite history of measles vaccination. After the mass immunization campaign in September, 2007, only 10 cases were reported in 2008 and the incidence rate was 1.58 per 100 000 heads, a 95.29% decrease in incidence rate in comparison with that of the last year. Conclusion The mass immunization campaign has achieved substantial results.
ObjectiveTo investigate the situation of hospital infection with bacteria producing extended-spectrum β-lactamases (ESBLs), find the source of infection and analyze its transmission route, and take effective prevention and control measures to reduce the incidence of nosocomial infection. MethodsA hospital neonatal ward had six cases of ESBL-producing bacteria infections on February 16 to 26, 2012. According to the processing procedure for hospital infection outbreak, we carried out epidemiological investigation on the patient with suspected hospital infection, including checking the medical records, asking the doctor in charge about the patients'clinical symptoms, collecting sputum samples of the patients and environmental microbiology examination, etc. ResultsFour cases of infection were community-acquired, and two were nosocomial infection. Infection onsets were concentrated (between February 16 and February 26, 2012). Patients had similar clinical symptoms, including fever, cough, cough sputum, and lung wet rales, which showed a lower respiratory infection. Six strains of ESBL-producing Escherichia coli were isolated from the infected children, and their susceptibility reports were not entirely consistent, indicating that they did not belong to the same species and were not homologous pathogens. Through bedside survey, we also isolated from the environmental samples 6 ESBL-producing bacteria, and these bacteria were acquired from the milk countertops, kettle, ventilator tube, two doctors'nasal cavity, and the cleaners'nasal cavity in corresponding wards of those infected children. ConclusionThe infection does not belong to an outbreak of nosocomial infection, and it is only an aggregation event of ESBL-producing Escherichia coli. The symptoms of infection were mainly because of lower immunity of children themselves, plus not so good aseptic technique and management in the department of neonatology. Therefore, strengthening hand hygiene management of medical staffs, and regular environmental sanitation and disinfection can reduce the incidence of neonatal hospital infection.