The monitoring of nosocomial infections and control of an outbreak in a surgical intensive care unit / 解放军医学杂志

ABSTRACT

Objective To investigate the incidence and the risk factors of nosocomial infection in a surgical ICU (SICU) where infections occurred frequently. Methods A bacteriological investigation was prospectively done in all the inpatients of the SICU admitted in one month. Nosocomial infection was diagnosed according to Diagnostic Criteria of Nosocomial Infection published by Ministry of Health. The nurse who was responsible for the study should observe each patient carefully and fill in the progress note and monthly report of each ICU patient every day. When a case of infection was found, it should be recorded in the Record of Nosocomial Infection Case. The data were analyzed after the completion of the study. Results All the inpatients had undertaken prolonged use of interventional equipments such as urethral catheter, arterial or venous cannula, artificial ventilation, etc. The nosocomial infection rate was 22.7% in 22 inpatients. The daily infection incidence of urinary tract, blood, and lung was 26.8‰, 9.5‰, and 65.8‰, respectively. One patient was found to have pulmonary infection, urinary tract infection and bacteremia simultaneously. From the specimens from patients with nosocomial infection pathogenic bacteria were identified, including Stenotrophomonas maltophilia, Streptococcus viridans, Staphylococcus epidermidis, Pseudomonas aeruginosa, E. coli, Staphylococcus aureus, Achromobacter xylosoxidans, and Candida tropicalis were isolated. At the same time the drug sensitivity tests were carried out. During the monitoring period an outbreak of infection was controlled. Conclusions The aim of an objective monitoring is to solve the clinical problem and cut down the infection rate. In this group there are many risk factors, including old age, malignant tumor, major operation, severe pathological condition, long duration of stay, and so on. SICU is the department where rate of nosocomial infection is high. Comprehensive control measures must be carried out to lower the incidence of nosocomial infection.