ObjectiveTo explore the risk factors of nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy.MethodsThe children with acute lymphoblastic leukemia who were admitted to the Department of Pediatrics, Huai’an First Hospital Affiliated to Nanjing Medical University between December 2012 and December 2018 were divided into the infection group (including the severe infection subgroup and the non-severe infection subgroup) and the non-infection group according to whether nosocomial infection occurred during induction and remission chemotherapy. The clinical data of patients were collected. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of nosocomial infection during induction remission chemotherapy in children with acute lymphoblastic leukemia.ResultsA total of 96 patients were included. There were 67 cases in the infection group (26 in the severe infection subgroup and 41 in the non-severe infection subgroup) and 29 cases in the non-infection group. Univariate analysis showed that the granulocyte deficiency time and the prevalence of skin and mucosal damage in the infection group were significantly higher than those in the non-infection group, and the infection group had significantly lower laminar bed use and serum albumin level than the non-infection group did (P< 0.05). Multivariate logistic regression analysis showed that prolonged agranulocytosis [odds ratio (OR)=23.075, 95% confidence interval (CI) (3.682, 144.617), P=0.001], skin and mucosal lesions [OR=12.376, 95%CI (1.211, 126.507), P=0.034], hypoalbuminemia [OR=5.249, 95%CI (1.246, 22.113), P=0.024] were independent risk factors for nosocomial infection during induction and remission of childhood acute lymphoblastic leukemia, while laminar bed [OR=0.268, 95%CI (0.084, 0.854), P=0.026] was the protective factor.ConclusionsLong-term agranulocytosis, skin and mucosal lesions, and hypoalbuminemia are independent risk factors for nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy. Laminar flow bed is its protective factor.
Objective To investigate the prognostic factors and hospitalization cost in patients diagnosed as central line-associated bloodstream infection( CLABSI) in intensive care unit( ICU) .Methods A retrospective study was made to investigate the CLABSI epidemic data in ICU from June 2006 to June 2009. Clinical and physiological parameters were summarized and compared between these patients, which were divided into two groups based on the clinical outcome. Meanwhile, events including blood transfusion,mechanical ventilation, as well as cost of hospitalization were also reviewed. Logistic regression method was introduced to investigate the potential prognostic risk factors. Results There were 49 patients were diagnosed as nosocomial CLABSI, in which 19 cases( 38. 8% ) died in the hospital and 30( 61. 2% ) weresurvival. In univariate analysis, differences in body temperature, central venous pressure, acute physiology and chronic health evaluation( APACHEⅡ ) score, blood transfusion amount, pH value, D-dimer, blood serum alanine transarninase, blood urea nitrogen level, serumcreatinine, serumpotassiumbetween the survivors andthe non-survivors were significant( P lt;0. 05) . However, no significant differences were observed between the two groups in in-hospital days, ICU days and hospitalization cost ( all P gt; 0. 05) . With multiple logistic regressions, higher APACHEⅡ score( OR 0. 78; 95% confidence interval: 0. 66-0. 94; P = 0. 007) , APTTlevel( OR 0. 87; 95% confidence interval: 0. 77-0. 98; P = 0. 026) and serum potassium( OR 0. 09; 95% confidence interval: 0. 01-0. 80; P = 0. 031) were independent predictors of worse outcome. Conclusions Disease severity and coagulation situation may directly predict the prognosis of nosocomial CLABSI patients.But current investigation did not demonstrate significant differences in ICU length of stay and respective cost between the CLABSI patients with different prognosis.
Objective To explore the role and significance of full-time infection control nurses in the prevention and control of nosocomial infection in Intensive Care Unit (ICU). Methods Before Februry 2013, there was no full-time infection control nurses in ICU in West China Hospital of Sichuan University (before implementation); since March 2013, with a comprehensive evaluation of bed numbers and infection control nurses workload, the job of full-time infection control nurses were initiated (after implementation). The management of infection control was achieved through clarifying the responsibility of full-time infection control nurses, the implementation of infection monitoring and other related measures. Results Comparing to the condition before implementation, the hand hygiene compliance among nurses, doctors, workers and cleaners in ICU elevated from 49.8% to 74.9%, the infected rate decreased from 15.3% to 9.3%, the positive rate of multiple resistant bacteria decreased from 18.3% to 13.5%, the incidence of ventilator-associated pneumonia decreased from 13.02‰ to 6.63‰, and central venous catheter-related bloodstream infection rate decreased from 6.559‰ to 2.422‰; the differences were all significant (P<0.05). The incidence of urinary tract infection decreased from 1.21‰ to 1.07‰, and the difference was significant (P>0.05). Conclusions Full-time infection control nurses can introduce continuous and effective training to medical staffs, supervise the execution of hospital infection prevention and control measures, and examine all steps involved and relevant feedbacks. Therefore, the full-time infection control nurses play an important role in the prevention and control of nosocomial infection in ICU.
In order to identify the incidence of nosocomial pulmonary infection in surgical critical care patients in our hospital, we studied 800 patients discharged from surgical intensive care unit between May 1992 to Dec. 1994. One hundred and six episodes of pulmonary infection were found in 96 cases, in which 20 cases had been re-infected. The infection rate was 12.0%. The age of patients, APACHE- Ⅱ score and duration in ICU were closely related to the incidence of pulmonary infection. Tracheal intubation, tracheotomy and mechanical ventilation were the predisposing factors. The prevalent pathogens were pseudomonas aeruginosa, acinetobacter, staphylococcus aureus and candida albicans. 54.7% of cases were infected with more than one pathogens, and 36.8% of cases had fungal infection. The prevention and treatment are also discussed.
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.
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 analyze the trend of hospital infection, so as to provide a scientific basis for hospital infection prevention and control. MethodsFrom 2011 to 2013, according to the criteria of diagnosis of nosocomial infections set up by the Ministry of Health, the prevalence rates of nosocomial infections in patients who were hospitalized on the survey day were investigated by the combination of bedside investigation and medical records checking. ResultsThe incidence rates of nosocomial infections from 2011 to 2013 were 2.99%, 2.31% and 1.95%, respectively, presenting a downward trend. The rate of hospital infection was the highest in comprehensive Intensive Care Unit, and the main infection site was the lower respiratory tract. Gram-negative bacteria were the main pathogens causing hospital infections, including Klebliella pnermoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Escherichia coli. The utilization rates of antibacterial agents in these three years were respectively 39.84%, 34.58% and 34.22%. ConclusionTargeted surveillance and management of key departments and sites should be strengthened. It is necessary to strengthen the surveillance and management of antibiotics, raise the submission rate of pathogens, and use antibiotics appropriately.
ObjectiveTo investigate the prevalence rate of nosocomial infection in West China Hospital of Sichuan University and to analyze the implementation effect of nosocomial infection control measures, so as to provide reference for infection control.MethodsAn investigation of the prevalence rate of nosocomial infections was performed on patients who were admitted in West China Hospital of Sichuan University from 0:00-24:00 on a day of every late June from 2012 to 2018 by using bedside investigation in combination with inpatient medical record query, and the data was verified, summarized, and statistically analyzed by the professionals of Nosocomial Infection Management Department.ResultsFrom 2012 to 2018, the prevalence rates of nosocomial infections were 5.19%, 4.20%, 3.94%, 4.26%, 4.29%, 4.25%, and 2.97% in West China Hospital of Sichuan University, which tended to decline (χ2=32.826, P<0.001). There was no significant difference in annual total infection rate in the Department of Internal Medicine, however, the infection rate in the Department of Hematology tended to decline (χ2=6.127, P<0.05); in the Department of Surgical Medicine, the total infection rate tended to decline(χ2=18.721, P<0.001); in particular, the infection rate in the Department of Thoracic Surgery tended to decline(χ2=3.906, P<0.05); the annual difference in infection rate in the Intensive Care Unit (ICU) was not statistically significant. The key site of nosocomial infection was dominated by the lower respiratory tract, and the annual difference was not statistically significant. In particular, postoperative pneumonia has increased since 2014 (χ2=9.56, P=0.002). The nosocomial pathogens which had the highest constituent ratio over the years were Acinetobacter baumannii (in 2012, 2013, 2014, 2017, and 2018), Klebsiella pneumonia (in 2015), and Escherichia coli (in 2016). The annual difference in rate of antimicrobial use was not statistically significant(χ2=3.75, P=0.053), while the rate of antimicrobial use in the ICU tended to decline (χ2=30.42, P=0.000).ConclusionsThe prevalence rate of nosocomial infection in West China Hospital of Sichuan University tends to decline. However, sufficient attention still requires to be paid to lower respiratory tract infection, particularly for patients with postoperative pneumonia.
ObjectiveTo compare the point prevalence of nosocomial infection in a comprehensive hospital between 2014 and 2015, and to put forward prevention and control measures so as to reduce the incidence of nosocomial infection. MethodsBy means of reviewing electronical medical records and beside investigation, the prevalence rates of nosocomial infection in patients hospitalized on June 4, 2014 and June 16, 2015 were investigated. Data were collected by a uniform questionnaire and analyzed by Excel 2007 and SPSS 18.0. ResultsThe nosocomial infection rates in those two time points were respectively 4.51% and 3.21% without a significant difference (χ2=2.246, P=0.134). Intensive Care Unit, Department of Neurosurgery and Department of Orthopedics were listed in the top five in terms of nosocomial infection rate for two consecutive years. The nosocomial infection sites were mainly lower respiratory tract, and a total of 64 strains were detected including mainly G? bacteria accounting for 76.6%. Antimicrobial agent usage covered 34.05% and 33.33% at those two time points. The purpose was mainly for therapy, and the pathogenic bacteria specimen detection rate was 68.06% and 59.73%, without statistically significant difference (χ2=0.114, 3.311; P>0.05). ConclusionThe prevalence of nosocomial infection in this hospital is at average national level but higher than the average level in Sichuan Province. Infection surveillance, prevention and control measures should be strengthened in key departments and key infection sites, and antimicrobial agent should be rationally used so as to reduce the incidence of nosocomial infection.
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.