ABSTRACT
Objective To evaluate the occurrence and risk factors for healthcare-associated infection(HAI)in pre-mature infants.Methods The occurrence of HAI among premature infants who were born in a hospital from Janu-ary 2011 to June 2015 and admitted in the neonatal intensive care unit within 24 of birth were investigated prospec-tively,the related risk factors and intervention measures were analyzed.Results 644 premature infants were inves-tigated,32(4.97%)had HAI,the main infection site was lower respiratory tract (n=18,56.25%).34 pathogenic isolates causing HAI were detected, 24 (70.59%) were gram-negative bacteria, the major was Klebsiella pneumoniae (n=14);10 isolates were gram-positive bacteria(29.41%).Logistic regression analysis revealed that small for gestational age, low birth weight, severe amniotic fluid pollution, mechanical ventilation, feeding intolerance,indwelling gastric tube,irrational antimicrobial use,and long length of hospital stay were risk factors for HAI in premature infants (all P < 0.05).Conclusion Risk factors for HAI in premature infants are multiple, targeted interventions,such as shorten the length of hospital stay,reduce unnecessary invasive operation,use antimicrobial rationally,improve the feeding tolerance,are helpful for reducing the risk factors for HAI in premature infants.
ABSTRACT
Objective To investigate the cleaning quality of frequently touched object surfaces in a hospital,so as to formulate effective evidence-based intervention measures.Methods Frequently touched object surfaces in common wards,operating rooms,and intensive care unit(ICU)of the hospital between October 2014 and February 2015 were labeled by fluorescent adhesive agents 1 -2 times a week,objects were labeled before patients’discharge and at the end of operation,cleaning quality of frequently touched object surfaces were checked after routine cleaning. Results A total of 2 131 object surfaces were monitored,fluorescent adhesive agents on 1 732 objects were cleared, clearance rate was 81 .3%,hygienic clean was qualified.642,650,and 839 objects surfaces in common wards, operating rooms,and ICU were monitored respectively,the clearance rates were 82.1 %,75.8%,and 84.9%respectively,the clearance rates among three wards were significantly different (χ2 =19.964,P <0.001 ).In com-mon wards,fluorescent clearance rates of call buttons,power switches,and equipments were 51 .3%,55.2%,and 58.5% respectively;in operating room,fluorescent clearance rates of room wall,control panel of anesthesia ma-chine,bed-adjusting device,keyboards,and infusion pumps were 38.6%,48.8%,60.0%,61 .3%,and 68.4%,re-spectively;in ICU,fluorescent clearance rates of equipments was 65.9%,all were unqualified.Conclusion The en-vironmental hygiene quality is generally qualified in this hospital,but the cleaning quality of frequently touched ob-ject surfaces needs to be further improved.
ABSTRACT
Objective To investigate healthcare-associated infection (HAI)in neonatal intensive care unit(NICU),and provide reference for controlling HAI in newborns.Methods Targeted surveillance on HAI in all newborns in NICU of a hospital from January 2011 to December 2013 was performed by prospective investigation method.Results A total of 5 365 newborns were monitored,128 newborns developed 133 times of HAI,HAI rate and HAI case rate was 2.39% and 2.48% respectively.The major infection sites were conjunctiva (33.08%),upper respiratory tract (23.31%)and skin soft tissue (17.29%).The daily infection rate was 3.32‰(128/38 528),vascular catheter usage rate and respirator usage rate was 1.75%(676/38 528)and 1.09%(420/38 528)respectively.The difference in vascular catheter usage rate and res-pirator usage rate in newborns with different body weight had statistical difference (χ2 =3 075.22;442.46,both P 2 500 g was 16.67%, 12.26%,4.15% and 1.06% respectively.None newborns developed catheter-related bloodstream infection(CRBSI),the incidence of ventilator-associated pneumonia (VAP )was only 4.76‰(2/420).A total of 51 specimens were sent for de-tection,27 pathogens were isolated,the major were gram-positive bacteria(55.56%).Conclusion The incidence of HAI in newborns is high,the main infection sites are eye,upper respiratory tract,and skin and soft tissue.
ABSTRACT
OBJECTIVE To study the distribution and drug resistance of nosocomial infection(NI) pathogens.METHODS The NI pathogens collected between Jan 2002 and Dec 2008 were completely surveyed and analyzed.RESULTS Totally,9518 samples were cultured to find NI pathogens,in which 6703 NI pathogens were isolated.In the pathogens,G-pathogens occupied 59.5%,G+ cocci 25.0%,and fungi 15.5%.The rate of ESBLs in E.coli was reached to 47.8%,and that in K.pneumoniae was 29.4%;The first two predominant G+ pathogens were Staphylococcus aureus(11.7%) and Enterococcus(5.7%).The rate of MRSA in S.aureus was 78.2%,and that of VRE in Enterococcus was 2.3%,The pathogens of fungus were mainly Candida albicans(10.2%).CONCLUSIONS The G-NI pathogens are markedly increased year by year and become the first important instead of G+ cocci,meanwhile the multiple drug resistance and ESBLs pathogens are also markedly increased.
ABSTRACT
OBJECTIVE To explore a management method for the prevention and control of infectious diseases in hospital. METHODS We applied the PDCA (plan,do,check and action) model to establish a management strategy for the prevention and control of infectious diseases for three years. The components of the management model included providing educational program for medical staff,designing and realizing direct network system for infectious disease reporting,monitoring diagnosed infectious diseases ,analyzing their epidemic tendency,guiding medical staff to prevent and control infectious diseases,and strengthening the surveillance,feedback,rewards and punishment. RESULTS The rate of delayed or missed report of infectious diseases was decreased from 5% to 1.1% by monthly check and from 6.8% to 0% by seasonally cross check. Although 46 cases of AIDS,5 cases of caesarean birth with HIV possitive and 1445 cases of hand-foot-mouth disease were admitted in our hospital,No medical staff and other patients was crossly infected. CONCLUSIONS Our way of management based on PDCA model can strengthen the prevention and control of infectious diseases and assure medical quality and patient safety.