ABSTRACT
Objective To investigate the infection state and tendency in Tianjin Chest Hospital from 2014 to 2016,and provide scientific basis for making strategy to prevent and control nosocomial infection. Methods With bedside investigation and medical case review,one day every year was selected as the day of investigation to survey the healthcare-associated infections in our hospital during 2014-2016. Data of operative incision, infection condition, the usage of anti-bacterial agents and bacteria detection were collected and organized for further study. Results A total of 2 285 patients were investigated during 2014 to 2016, in which nosocomial infection was found in 55 cases. The total prevalence of healthcare-associated infections was 2.41%. The prevalence rates of healthcare-associated infections in each year were 2.62%,2.63% and 2.05% respectively,and no significant differences between them(χ2=0.750,P>0.05).In the three years, the highest prevalence rates were found in Department of Cardiac Surgery(13.79%),Department of Cardiac Surgery(7.48%) and Department of Endocrine (7.41%) respectively. The lower respiratory tract infection was the main infection site of nosocomial infection (61.11%-78.95%), followed by upper respiratory tract infection, urinary tract infection and blood infection. In 2014-2016, pathogenic detection rates for specimens were 77.78%, 85.71% and 88.89% from patients with nosocomial infection (χ2=0.735,P>0.05). Forty-five strains of pathogen were isolated from 2014 to 2016. The main pathogen was the gram-negative bacteria,and 32 strains were isolated during the three years,which accounted for 71.11%. Six strains of gram-positive bacteria were isolated,which accounted for 13.33%.Seven strains of fungus were isolated,which accounted for 15.56%. The predominant pathogens were Klebsiella pneumonia (10 isolates), Pseudomonas aeruginosa (8 isolates) and Acinetobacter baumannii (5 isolates). The antibiotic utilization rates were 28.40%, 29.17% and 23.74% respectively from 2014 to 2016 (χ2=7.175,P<0.05). In the three years, most of antibiotics were used therapeutically, accounting for 83.39%,14.17% received for prophylactic use,and 2.44% received for both prophylactic use and treatment (χ2=29.151,P<0.05). The rates of bacteria detection in patients who received therapeutic use were 77.02%, 74.42% and 75.77% respectively(χ2=0.306,P>0.05).Conclusion The prevalence of healthcare-associated infection of Tianjin Chest Hospital is maintained at a stable level.The monitoring and prevention of key departments,sites and predominant pathogens should be strengthen, and effective measures for preventing and controlling nosocomial infection should be formulated scientifically,so as to reduce the incidence of nosocomial infection.