Current status and trends of nosocomial infection in Zhejiang University affiliated Children′s Hospital from 2005 to 2014

Abstract

Objective To investigate the status and trends of nosocomial infection in children′s hospital to provide references for prevention and control of nosocomial infection. Methods The retrospective study were conducted to analyze the data of nosocomial infection at Zhejiang University affiliated Children′s Hospital from 2005 to 2014. Results A total of 357 684 discharged patients were studied, nosocomial infection occurred in 13 934 cases. The mean infection rate was 3.9%(1.72%-5.80%). The top five department of nosocomial infection rate were the department of hematology (14.47%), neonatal intensive care unit (NICU, 11.63%), surgical intensive care unit (SICU, 6.45%), gastroenterology (4.52%) and newborn nursery (4.33%). The infection rate in NICU and SICU became the first and second place in 2014, which were 17.55% and 8.30%, respectively. The distributions of nosocomial infection site were upper respiratory tract infection (36.79%), gastrointestinal tract infection (22.76%), lower respiratory tract infection (21.40%) and sepsis (14.55%). The proportion of upper respiratory tract infection had declined year by year from 51.08% to 15.78%, while the proportion of lower respiratory tract infection and sepsis had increased from 15.92% to 35.92% and from 11.18% to 22.50%, respectively. The proportion of gastrointestinal infections remained high. The constitution of infection sites in different departments were different. The digestive tract infection (69.93%) were dominant in the department of neonatology, sepsis (56.51%) in the department of hematology, and the lower respiratory tract infection in NICU, SICU, PICU and cardiothoracic surgery departments were above 60%. Regarding the constitution of the pathogenic microorganisms, 49.29% were virus infection, 34.25% gram negative bacterial infection, 12.75% gram positive bacterial infection and 3.14% fungus infection with no remarkable changes. Rotavirus was the most common pathogen causing nosocomial infection, followed by Klebsiella pneumoniae and Acinetobacter baumannii. The detection rate of (intensive care unit, ICU) multidrug-resistant bacteria increased gradually. Conclusions The mean incidence of nosocomial infection in children′s hospital demonstrats a decreasing trend, while the infection rates in NICU and SICU have increased within years. The contributions of lower respiratory tract infections and sepsis have also increased, as well as the detection rate of ICU multidrug-resistant bacteria. Rotavirus is the most common pathogen causing digestive tract infection. Key words: Nosocomial infections; Children′s hospital; Review; Change trend