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Objective To investigate perioperative antimicrobial prophylaxis in arthroscopic surgery in a hospital before and after intervention,evaluate intervention efficacy,and provide evidence for the rational clinical antimicro-bial application.Methods From August 2012,measures were taken to intervene perioperative antimicrobial use, perioperative antimicrobial use and surgical site infection(SSI)in 312 patients undergoing arthroscopic surgery be-tween September 2011 and August 2013 were retrospectively surveyed.Results A total of 312 patients were investi-gated,pre-and post-intervention were 150 and 162 cases respectively,SSI rates were both 0 before and after inter-vention. Antimicrobial usage rate after intervention was lower than before intervention (26.54% vs 100.00% ,χ2=1.781,P<0.001). Irrational antimicrobial use dropped obviously;average expense of antimicrobial agents dropped from (1165.69±756.33)yuan (RMB)before intervention to (32.71 ±119.29)yuan (RMB)after intervention (t= 3.330,P<0.001).Conclusion Perioperative antimicrobial usage rate in arthroscopic surgery at this hospital decreased significantly after intervention,rational use of antimicrobial agents has improved,SSI rate still remains zero.
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Objective To investigate the status of tuberculosis (TB)infection among health care workers (HC-Ws)in an infectious diseases hospital,and explore the risk and influencing factors of TB infection.Methods All HCWs in an infectious diseases hospital were surveyed through questionnaire and purified protein derivative (PPD) testing.Results Incidence of TB infection among all HCWs in this hospital was 48.18%.There was no significant difference in TB infection among HCWs in different departments(P >0.05).TB infection among HCWs of different working seniority,different ages,and different job titles were all significantly different (all P <0.05).Risk factors for TB infection were education level,job title,living condition,and working time in TB clinics or wards,OR (95%CI )were 1 .70(1 .03-2.80),1 .95(1 .10-3.45),1 .84(1 .03-3.28),and 2.38(1 .40-4.04)respectively;personal protection was a protective factor for TB infection (OR,0.92 [95% CI ,0.85 - 0.99]).Conclusion HCWs in in-fectious diseases hospital are at high risk of TB infection,they should improve their self-protection consciousness, and take protective measures as early as possible.
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Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.
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Objective To investigate the incidence and risk factors of surgical site infection(SSI)in neurosurgical patients in a tertiary first-class hospital,and provide reference for the prevention and control of SSI.Methods 47 neurological patients with SSI (49 patients developed SSI,2 were excluded from study due to the lack of appropriate control subject)from December 31 ,2011 to December 31 ,2012 were as infected group,and 94 patients without SSI (1 ∶2 matching)were as non-infected group,risk factors for SSI were analyzed retrospectively.Results There was no significant difference in general condition of two groups of patients (all P >0.05 );among 3 708 patients,49 (1 .32%)developed SSI;intracranial infection was the main type of SSI (89.80%);27 patients were performed ce-rebrospinal fluid (CSF)bacteriological detection,6 (22.22%)of whom were positive for CSF bacteriological detec-tion.Univariate conditional logistic regression analysis showed that risk factors for SSI in neurosurgical patients were operational risk assessment score (OR =2.04),frequency of preoperative antimicrobial use(OR =3.15 ),fre-quency of intraoperative antimicrobial use(OR=2.58),duration of operation(OR=2.70),surgical blood loss(OR=1 .72),indwelling drainage tube(OR=4.30),duration of indwelling drainage tube after operation(OR=2.06),and time for initial dressing change(OR=1 .66);Multivariate conditional logistic regression analysis showed that the in-dependent risk factors for SSI were frequency of preoperative antimicrobial use(P =0.03,OR =4.86),duration of operation(P =0.05,OR = 2.89 ),and time for initial dressing change after operation (P = 0.01 ,OR = 1 .92 ). Conclusion Risk factors for SSI in department of neurosurgery are multiple,duration of operation,duration of in-dwelling drainage tube after operation,and time for initial dressing change after operation are major risk factors.
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Objective To investigate the causes and treatment measures of an outbreak of Norwegian scabies oc-curred in a hospital.Methods In May 2013,an outbreak of Norwegian scabies among health care workers(HCWs) occurred because of the misdiagnosis of a patient with Norwegian scabies,epidemiological investigation was carried out by healthcare-associated infection(HAI)control department,medical intervention and disinfection and isolation measures were performed.Results A total of 27 HCWs and patients’relatives developed Norwegian scabies.After active medical treatment,patients’condition improved;all appliances used by patients were cleaned and disinfected after being wrapped and sealed with plastic bags for one week.Epidemic trend of infection was under control and no new case was found.Conclusion With highly contagious,Norwegian scabies can be spread in local area,it is neces-sary to improve HCWs’diagnostic ability to this disease and take effective measures to prevent the epidemic once HAI occur.
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Objective To understand the distribution and antimicrobial resistance of pathogens isolated from bone and joint infection sites of orthopedic patients,so as to provide reference for prevention and therapy of bone and joint infection.Methods 114 specimens from bone and joint infection sites of orthopedic patients between June 2010 and October 2013 were surveyed,pathogens and antimicrobial susceptibility of pathogens were analyzed.Results A total of 145 pathogenic isolates were obtained,62.07%(n=90)of which were gram-negative bacteria,34.48%(n=50)were gram-positive bacteria,2.07%(n=3)were Candida spp .,and 1 .38%(n =2)were anaerobic bacteria. The top 4 pathogens were Pseudomonas aeruginosa (20.69%),Staphylococcus aureus (12.41 %),Escherichia coli (11 .03 %),and Enterobacter cloacae (9.65%).These pathogens presented remarkable resistance.The resistant rate of Pseudomonas aeruginosa to ceftazidime was up to 40.00%;the resistant rates of Escherichia coli to com-pound sulfamethoxazole,ciprofloxacin and levofloxacin were all 100.00%.Conclusion Gram-negative bacteria are the major pathogens in orthopedic ward,the isolated strains are resistant to multiple antimicrobial agents.