Impact factors analysis of standardized perioperative antibiotic application on nosocomial infection and drug-resistance bacteria

Abstract

To investigate the impact factors and clinical significance of standardized perioperative antibiotic application on nosocomial infection and drug-resistant bacteria strains in eye hospital. It was a retrospective series case study. The inpatients underwent ophthalmologic operation of one year before standardized application (from Sep. 2009 to Aug. 2010) and one year after standardized application (from Sep. 2010 to Aug. 2011) in Tianjin Eye Hospital were selected and the incidence rate of nosocomial infection and types of drug-resistant strains in these two years were analyzed. From Sep. 2009 to Aug. 2010, the prophylactic antibiotics application rate for type I incisional surgeries was 80.29% (12937/16 111), the nosocomial infection rate was 0.011% (2/17 563). From Sep. 2010 to Aug. 2011, the same values were 44.50% (7968/17 905) and 0.005% (1/19 441). There was a significant decrease of prophylactic antibiotics application comparing these two years (χ(2) = 4587.78, P < 0.05). However, there was no significant difference in nosocomial infection rate (χ(2) = 0.44, P > 0.05). Average antibiotics application rate for inpatient (type I-IV incisional surgeries) was 76.69% (13 469/17 563) from Sep. 2009 to Aug. 2010, and 49.40% (9604/19 441) from Sep. 2010 to Aug. 2011. There was a significant decrease over these two years (χ(2) = 2927.19, P < 0.05). The results of isolation and cultivation of bacteria in these two years showed that staphylococcus epidermidis predominated in gram-positive bacteria, pseudomonas aeruginosa predominated in gram-negative bacteria. Drug resistance rate of staphylococcus was 42.86% (33/77) from Sep. 2009 to Aug. 2010 and 39.19% (39/74) from Sep. 2010 to Aug. 2011. Drug resistance rate of pseudomonas aeruginosa was 2/11 from Sep. 2009 to Aug. 2010 and 2/13 from Sep. 2010 to Aug. 2011. There were no significant differences in drug resistance rate of staphylococcus and pseudomonas aeruginosa between these two years (χ(2) = 0.09, P > 0.05, χ(2) = 0.03, P > 0.05). By standardizing the perioperative antibiotics application in eye hospital, the rate of systemic administration of antibiotics declined gradually. The Choices and the administrative mode of antibiotics were more rational than before. In the meanwhile, the rate of nosocomial infection and drug-resistance did not increase. Therefore, avoiding the drug abuse ensured the medical safety, which was worthy of further study.