Incidence Of Hospital Infection Research Articles

TRACKING OF MICROORGANISMS ON THE SURFACE AND IN SERVERS A THE PUBLIC HOSPITAL IN PALMAS-TO

Hospital infection (HI) is a public health problem in Brazil. Resistant bacteria increase the risk of superinfections and raise the number of deaths, factors that may be associated with failures in antiseptic and environmental disinfection processes, favoring cross-contamination. This study investigated the presence of microorganisms on hospital surfaces, on employees' hands and nostrils, and analyzed retrospective infections suspected of hospital infection at a Public Hospital in Palmas, TO. The results revealed the predominant presence of microorganisms of the genus Staphylococcus. The analysis indicated shortcomings in antiseptic and disinfection procedures, highlighting the urgent need for more rigorous biosafety measures. The research emphasizes the importance of appropriate antimicrobial protocols to prevent and treat Healthcare-Associated Infections (HAIs) and underscores the need for awareness and training of healthcare professionals. The study also points to the growing antimicrobial resistance and frequent identification of multidrug-resistant strains. These findings have significant implications for improving patient safety in hospital settings and provide a solid foundation for the development of effective strategies for the prevention and control of nosocomial infections, aiming to reduce the incidence of HI and enhance the quality of healthcare.

Nosocomial Infections Associated with Caesarean Section

Nosocomial infections, also called health-care-associated or hospital-acquired infections, are a subset of infectious diseases acquired in a health-care facility. Historically, Staphylococci, Pseudomonas, and Escherichia coli have been the common known as nosocomial infection bacteria. Moreover, nosocomial pneumonia, surgical wound infections, and vascular access-related bacteremia have caused the most illness and death in hospitalized patients; and intensive care units have been the epicenters of antibiotic resistance . Acquired antimicrobial resistance is the major problem, and vancomycin-resistant Staphylococcus aureus is the pathogen of greatest concern. The shift to outpatient care is leaving the most vulnerable patients in hospitals. Aging of our population and increasingly aggressive medical and surgical interventions, including implanted foreign bodies, organ transplantations, and xenotransplantation, create a cohort of particularly susceptible persons. Moreover, renovation of aging hospitals increases risk of airborne fungal and other infections . To prevent and control these emerging nosocomial infections, we need to increase national surveillance, "risk adjust" infection rates so that inter hospital comparisons are valid, develop more noninvasive infection-resistant devices, and work with health-care workers on better implementation of existing control measures such as hand washing . In this review we aimed to review the previous projects which study incidence of hospital infection among delivery women with caesarean section in hospitals. Also, to discuss about the nosocomial infections and its types. We will also review the most common way a nosocomial infection is acquired, and the most common cause of nosocomial infection. In order to the modes of transmission of infection. In addition to a way to prevent nosocomial infections in hospitals. KEYWORDS: nosocomial infections, caesarean section

Evaluation of hospital acquired infections in the tertiary intensive care unit: a three-year analysis

Introduction: Hospital-acquired infections (HAI) occurring in intensive care units (ICUs) are an important risk factor for mortality and morbidity. In some patient groups followed in ICUs, the risk of developing nosocomial infections increases even more. Especially, patients with end-stage renal disease (ESRD) carry a serious risk for HAI when they are hospitalized in ICUs. Our aim is to determine the rate and incidence of hospital infection, the distribution of infections and the most common microorganisms in our ICU, to initiate appropriate empirical treatment and to prevent the development of antibiotic resistance.
 Material and Method: A total 158 patients with a diagnosis of hospital-acquired infection hospitalized between January 2017 and December 2019 at general internal medicine intensive care unit, were included in this study. The clinical findings, culture results and laboratory data of the patients were recorded. According to years, the HAI rate, density and infection agents in the ICU were determined.
 Results: 158 episodes of nosocomial infections were detected in 128 of 556 patients who were hospitalized within three years. The hospitalization day was 9048, and the three-year ICU HAI rate was calculated as 29.19%. HAI density was 17.45 in 1000 patient days. Bloodstream infection was the most common (30.38%), followed by ventilator-associated pneumonia (28.48%) and catheter-related urinary tract infection (24.68%). Gram-negative microorganisms were the most common infectious agents. Among the Gram-negative bacteria, the most frequently isolated bacteria were A. baumannii, K. pneumoniae and P. aeruginosa. Among Gram-positive bacteria, Enterococcus spp. was most frequently isolated
 Conclusion: The risk of HAI is high in patients hospitalized in ICUs. In order to control nosocomial infections, HAI incidences and rates should be evaluated, infectious agents, and prospective effective infection control strategies should be developed by taking necessary precautions according to surveillance results. These measures will significantly reduce the incidence of HAI.

Plan-Do-Check-Action Circulation Combined with Accelerated Rehabilitation Nursing under Computed Tomography in Prevention and Control of Hospital Infection in Elderly Patients Undergoing Elective Orthopedic Surgery.

To explore the adoption of plan-do-check-action (PDCA) circulation combined with accelerated rehabilitation nursing based on gemstone spectral imaging computed tomography (GSICT) in the prevention and control of hospital infection in the elderly patients undergoing the elective orthopedic surgery, 80 elderly patients who underwent the elective orthopedic surgery in the hospital were selected. Then, according to the randomized controlled principle, these 80 patients were divided into control group (40 cases) with conventional nursing and observation group (40 cases) with accelerated rehabilitation surgical nursing combined with PDCA circulation. All the patients underwent the GSICT examination without any contraindicators. Compared with the conventional CT scan, metal artifacts in GSICT were considerably reduced. In the images processed by GSI and metal artifacts reduction system (MARS), metal artifacts were basically eliminated and the positions, forms, and edges of metal artifacts in the human body were clearly presented. Hospital infection occurred in 1 (2.5%) patient in the observation group and 5 (12.5%) patients in the control group, and the difference was statistically significant (P < 0.05). In terms of temperature increase, patients in control group (37.5%) had a remarkably higher value than that of observation group (7.5%). The increase rate of white blood cell (WBC) count in control group (12.5%) was obviously higher than that in observation group (2.5%). Besides, the differences were statistically significant (P < 0.05). After PDCA circulation combined with accelerated rehabilitation nursing mode was applied, the hospitalization time of observation group (5.3 ± 2.4 days) was markedly lower than that of control group (9.7 ± 3.8 days). Moreover, the total hospitalization cost of observation group (791.44 yuan) was notably lower than that of control group (4068.96 yuan), with significant differences (P < 0.05). Nursing satisfaction in observation group (92.5%) was higher than that in control group (77.5%), and the difference was statistically significant (P < 0.05). In short, GSICT could effectively reduce beam hardening artifacts and metal implant artifacts and improve image quality. Furthermore, accelerated rehabilitation nursing combined with PDCA circulation could effectively reduce the incidence of hospital infection and improve nursing satisfaction.

Study on the Effect of Strengthening Nursing Management on Preventing the Incidence of Hospital Infection

Study on the Effect of Strengthening Nursing Management on Preventing the Incidence of Hospital Infection

Influence of the Internet of Things management system on hand hygiene compliance in an emergency intensive care unit

Hand hygiene is a critical strategy for infection prevention in all healthcare settings. Automated electronic monitoring systems are expected to improve hand hygiene performance. To investigate the impact of the Internet of Things (IoT) management system on hand hygiene compliance among medical staff in an emergency intensive care unit (EICU). This retrospective observational study was conducted between July 1st, 2017 and February 28th, 2018 in a 19-bed EICU. The changes in hand hygiene compliance among 54 members of medical staff and the incidence of hospital infections were compared, counted, and analysed before and after implementing the IoT management system in the EICU that was initiated on November 1st, 2017. After the application of the IoT management system, the hand hygiene compliance rates among the members of the medical staff before (29.5% (3347/11,338) vs 57.9% (4690/8094), P<0.001) and after (59.9% (9915/16,556) vs 73.8% (17,194/23 286), P<0.001) the contact with patients and surrounding environment significantly improved. However, hand hygiene compliance among three cleaning staff did not significantly improve after the application. Moreover, there was no significant difference in healthcare-acquired infection rates (2.535% (9/355) vs 2.047% (7/342), P=0.667) nor in the detection rates of the four major multidrug-resistant bacteria in the EICU before and after the application of the IoT management system (P>0.05). The IoT management system significantly improved hand hygiene compliance among medical staff, except cleaners, in the EICU of one provincial hospital; however, the rates of nosocomial infection did not significantly decrease. The quality of hand hygiene implementation needs to be improved.

Application of failure mode and effects analysis on hospital infection control for gynecological malignant tumor

Objective To explore the effects of failure mode and effects analysis (FMEA) on hospital infection prevention for gynecological malignant tumor. Methods From January 2017 to December 2018, we selected 25 nurses and clinical staff of Department of Obstetrics and Gynecology in Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology as subjects by cluster sampling. And then, the gynecology hospital infection control group was built. Group members assessed the department's risk of hospital infection by FMEA and put forward improvements for the high risk factors. We compared the risk priority number (RPN) of gynecological malignant tumor patients, catheter-related bloodstream infection (CRBSI) and incidence of hospital infection before and after implementing FMEA. Results After implementing FMEA, the total score of RPN risk factors of gynecological malignant tumor patients decreased compared with those before implementation with statistical differences (P 0.05) . Conclusions FMEA has good application effects on hospital infection prevention for gynecological malignant tumor patients which can effectively reflect the weak link of hospital infection management to reduce the incidence of hospital infection of gynecological malignant tumor patients. Key words: Gynecology; Neoplasms; Hospital infection; Failure mode and effects analysis

Effects of propofol and midazolam on the prognosis of patients treated with noninvasive positive pressure ventilation

Objective To compare the effects of propofol and midazolam on the prognosis of patients treated with noninvasive positive pressure ventilation. Methods A prospective, single-blind, randomized controlled trial(RCT) was conducted in 90 patients who were treated with noninvasive ventilation for acute dyspnea in the ICU of the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University from October 2014 to December 2016.They were randomly divided into three groups according to the digital table, with 30 cases in each group.The control group was not given sedation treatment.The propofol group was given propofol 0.5~1 mg/kg, and then administered by intravenous infusion of 1 mg·kg-1·h-1 with a micropump.The midazolam group was given midazolam 0.05-0.1mg/kg, and then with intravenous infusion of 0.05-0.1 mg·kg-1·h-1 maintaining the patients' sedation goals(Ramsay score of 2). The vital signs and blood gas analysis indicators were recorded.The incidence of tracheal intubation, the incidence of hospital infection, length of ICU and hospital stay, mortality and sedation-related complications were compared. Results The tracheal intubation rate in the propofol group was similar to that in the midazolam group(20.0% vs.23.3%, χ2=2.65, P>0.05), while the tracheal intubation rate(46.7%) in the control group was significantly higher(χ2=4.21, 4.17, all P 0.05). The incidence rates of hospital infection in the propofol group and midazolam group were 6.6%(2 cases) and 10.0%(3 cases), which were significantly lower than 33.3%(10 cases) in the control group (χ2=4.32, 4.23, all P<0.05). Conclusion The use of mild sedation in patients of acute dyspnea treated with noninvasive positive pressure ventilation can improve the patients' tolerance rate, reduce the rate of tracheal intubation and the incidence of hospital infection, and decrease the length of ICU and hospital stay, without significant adverse reactions.There was no significant difference between propofol and midazolam. Key words: Propofol; Midazolam; Sedation; Continuous positive airway pressure; Respiration, artificial; Dyspnea; Cross infection; Prognosis; Comparative effectiveness research

Restrictive measure for the commercialization of antimicrobials in Brazil: results achieved.

ABSTRACTOBJECTIVE To assess whether the incidence of hospital infection by a resistant microorganism decreased after the implementation of the restrictive measure of the National Health Surveillance Agency for the commercialization of antimicrobials.METHODS A historical cohort study of medical records of adult patients admitted to a general and public hospital from May 2010 to July 2011. A cohort was formed with patients admitted in the period before the restrictive measure for the commercialization of antimicrobials (Phase I) and a second cohort was formed with patients admitted after the implementation of the restrictive measure (Phase II).RESULTS The instantaneous risk of hospital infection by a resistant microorganism was estimated at seven by 1,000 people-time (95%CI 0.006–0.008) in Phase I, and four by 1,000 people-time (95%CI 0.003–0.005) in Phase II of the study. The differences between the survival curves in the different phases of the study and stratified by age group were also significant (p < 0.05).CONCLUSIONS The results suggest that the implementation of the restrictive measure of the commercialization of antimicrobials by the National Health Surveillance Agency reduced the incidence of hospital infection by a resistant microorganism.

Antimicrobial susceptibility pattern of Klebsiella pneumoniae in the period 2013-2017

Introduction. Klebsiella pneumoniae is a Gram-negative nonmotile, encapsulated bacterium. It is a significant opportunistic pathogen, especially in hospital conditions, where most multidrug- resistant strains are present. The aim of this study was to determine the incidence of hospital infections caused by Klebsiella pneumoniae and the incidence of antimicrobial resistance of Klebsiella pneumoniae strains, routinely isolated from patients at the Clinical of Infectious Diseases of the Clinical Center of Vojvodina, in the period from January 1, 2013 to December 31, 2017. Material and Methods. A retrospective study included 1.647 patients with a diagnosis of infectious diseases of bacterial etiology treated at the Clinic of Infectious Diseases of the Clinical Center of Vojvodina. The analysis of primo-isolates from patient material (blood, urine, cerebrospinal fluid, wound/decubitus and throat cultures) was performed to examine the incidence of infections caused by Klebsiella pneumoniae and its antimicrobial resistance to antibiotics. Results. During the five-year study period, 93 primo-isolates of Klebsiella pneumoniae were isolated from urine cultures 52/272 (19.1%), throat swabs 13/108 (12%), wound swabs 12/120 (10.0%), blood cultures 13/285 (4.6%) and one isolate from the liver 1/47 (2.1%). Klebsiella pneumoniae isolates showed the highest sensitivity to tigecycline and colistin (100%). During the study, Klebsiella pneumoniae showed resistance to carbapenem in up to 100%, depending on isolates and the year of study. Conclusion. Klebsiella pneumoniae is a common cause of nosocomial infections. It is sensitive only to tigecycline and colistin (100%), and its resistance to carbapenems and other antibiotics is a major health concern.

Manual Operated Ultraviolet Surface Decontamination for Healthcare Environments.

The aim of this study was to evaluate the effectiveness of a new handheld equipment based on a mercury low-pressure vapor lamp. The Surface UV® device was tested in Staphylococcus aureus, Streptococcus mutans, Streptococcus pneumoniae, two strains of Escherichia coli, Pseudomonas aeruginosa, Candida albicans, and other clinical microorganisms isolated from different surfaces of a public health hospital. The incidence of hospital infections has increased in recent years. Despite the variety of available chemicals to reduce the microorganisms, the search for antimicrobial agents and the characterization of novel targets are a continued need. Also, the minimization of chemical procedures is a constant need, and the use of ultraviolet (UV) light as a germicidal device for microorganisms' inactivation has been an alternative and one possible approach for the reduction of contamination. The in vitro decontamination was performed by application of Surface UV in different species of microorganisms (study 1). The surface decontamination was carried out by application of Surface UV on each surface of hospital environment (study 2). The device presents ultraviolet C (UV-C) light at 254 nm and produces an irradiance of 13 mW/cm2 at a distance of 1 cm of the surfaces. The light dose was 0.78 J/cm2 for 60 sec of application in both studies. The results for in vitro decontamination indicated a log10 reduction factor of 6.5 for S. aureus, 6.7 for S. mutans, 6.2 for S. pneumoniae, 5.4 for E. coli, 5.2 for E. coli (ATCC 8739), 5.4 for P. aeruginosa, and 6.7 for C. albicans. The hospital level of microorganisms decreases more by 75% after the procedure. The study highlights the development and successful application of a new portable device that can reduce the risk of contamination in health settings. Our results suggest that Surface UV is efficient and may be an alternative decontamination method.

Effects of cleaning and disinfection of thermoplastic masks on hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma

Objective To investigate the effects of cleaning and disinfection of thermoplastic masks on the hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma (NPC). Methods A prospective study was performed among 102 patients receiving precise radiotherapy for NPC from 2013 and 2016, consisting of 18 patients with early-stage (I, Ⅱ) disease and 84 patients with advanced (Ⅲ, IV) disease. All patients were randomly divided into group A and group B using a random number table. For group A, the marker lines of thermoplastic masks were sandwiched by double plastic tapes; cleaning and disinfection plus ultraviolet (UV) disinfection were applied to the masks 1 h prior to radiotherapy and immediately after radiotherapy. For group B, only conventional UV disinfection was applied to the masks. The surface of the masks was examined and hospital infection during radiotherapy was evaluated. Results At the 18th radiotherapy, group A had a significantly lower mask surface colony count than group B (7.90±6.50 vs. 139.05±129.29 CFU/cm2,P=0.000). Group A also had a significantly lower incidence of hospital infection than group B (72.5% vs. 88.2%, P=0.046). For the patients with early stage NPC, particularly, there was no significant difference in the incidence of infection between the two groups (55.6% vs. 66.7%, P=0.629). For patients with advanced NPC, group A had a significantly lower incidence of infection than group B (76.2% vs. 92.9%, P=0.035). There were no significant differences in incidence rates of oral mucosal, skin, and respiratory system infections between the two groups (47.1% vs. 51.0%, P=0.692; 17.6% vs. 23.5%, P=0.463; 7.8% vs. 13.7%, P=0.338). In both groups A and B, the incidence of oral mucosal infection was significantly higher than the incidence rates of skin infection (P=0.001, 0.000) and respiratory system infection (P=0.004, 0.000). Conclusions Thermoplastic mask is one of the risk factors for hospital infection in patients receiving precise radiotherapy for NPC. Timely cleaning and disinfection plus UV disinfection can significantly reduce the surface colony count and the incidence of hospital infection in patients with NPC, particularly in those with advanced NPC receiving precise radiotherapy. The incidence of hospital infection is the highest in the oral mucosa, followed by the skin and the respiratory system. Key words: Thermoplastic mask; Cleaning disinfection; Hospital infection; Nasopharyngeal neoplasms/radiotherapy

The influence of the education for hand hygiene compliance combined with PDCA circle on the nosocomial infection

Objective To explore the influence of the education for hand hygiene compliance combined with PDCA circle on the nosocomial infection. Methods From March 2013 to September 2015, nursing staffs in our hospital from respiration medicine, oncology department and gynecological clinic were given the hand hygiene compliance education and PDCA circle.And the results were cleared up and observed.The qualification rate of hospital environment monitoring, the implementation rate of the prevention measures for hospital infection, the infection incidence of relevant indicators before and after the experiment were compared. Results After implementing, it was evident that the infection rate of clinic of gynaecology and obstetrics was decreased from 16.29% to 2.47%.The infection rate of oncology department was decreased from 27.12% to 16.10%.The infection rate of respiration medicine was decreased from 51.16% to 21.71%.And the differences were statistically significant.It was found that the air culture of the treatment room and the qualification rate of bacteriology monitoring of the objects' surface were significantly improved after monitoring the hospital's environment after the implementation of clinical experiment.The qualification rate of air culture of the treatment room was promoted from 91.21% to 96.76%.The qualification rate of bacteriology-monitoring of objects' surface was promoted from 86.78% to 93.44%.And the differences were statistically significant.The practice qualification rate of the medical staffs before and after the implementation were compared.The practice qualification rate was significantly improved after the implementation of PDCA circle.The qualification rate after the implementation was nearly 100%.And the difference was statistically significant by comparing the data before and after the implementation.In terms of the comparison of the way of infection of the patients before and after the implementation of the relevant experiment, the infection rate caused by the vagina, urinary tract and skin incision was significantly decreased in the obstetrics and gynecology department.The respiratory tract infection rate of the oncology department and respiration medicine was significantly decreased.There was statistical significance in terms of the differences between the above ways of infection. Conclusions Hand hygiene compliance education combined with PDCA circle can effectively reduce the incidence of hospital infection, improve the normalization of operation of medical staffs.It is meaningful for the research of microbial infection.It worth a clinical promotion and further study. Key words: Hand hygiene compliance education; PDCA circle; Nursing management; Hospital infection

Stopa bolničkih infekcija i angažovanost zaposlenih na neonatološkom odeljenju

Objective. The aim of our study was to compare staffing trends for physicians and nurses with hospital infections (HIs) rate at a neonatology department of tertiary care health facility. Methods. The prospective cohort study was conducted at Neonatology Department, Clinical Centre Kragujevac, Serbia. The incidences of neonates with HIs were calculated for each of the quarters during the 5-year period. The data about the number and structure of staff for each quarter of the study period were collected from the official work schedule lists of the department. Results. This study registered a total of 272 HIs occurring in 264 neonates. The incidence rate of patients with HIs was 13.36% and the incidence density of HIs was 5.85 per 1,000 patient-days. In the observed period the trend of incidence rate of patients with HIs was stable, but the trend of incidence density of HIs was increasing, however without statistical significance. The highest incidence rates of patients with HIs were recorded in the third quarter of all observed years respectively: 17.44% in 2012, 16.74% in 2013, 23.47% in 2014, 18.18% in 2015 and 22.74 in 2016. The average number of nurses in the first shift ranged from 5.0 to 7.0, but in second shift was 3.0 to 4.0 only, and the least number of nurses worked in the third quarter of each year. The average number of physicians in the first shift ranged from 2.33 to 4.47 and they were also the fewest in numbers in the third quarter. We observed strong negative correlation between the average incidence rate of patients with HIs and the average number of nurses in the first shift (r=-0.977, p=0.023). Conclusion. Optimal nurse and physician staffing of neonatal departments in developing countries and the avoidance of inter-quarter variations in number of staff at duty would decrease the incidence of HIs and probably create overall savings of the hospital budget.

Analysis on Risk Factors of Nosocomial Infection in Orthopedic Patients and Research on Nursing Strategies

Abstract Orthopedic patients mostly comprise traumatic patients and elderly or sick individuals. More patients with emergency surgery suffer from open wounds and serious pollution, and operation time is relatively long. Thus, orthopedic patients with surgical incision infection account for a large proportion of incidence of hospital infection. Orthopedic patients are also bedridden for long periods, and they receive poor bone tissue blood supply. In surgical incision infections, mild cases suffer from delayed wound healing, whereas severe cases can form osteomyelitis. This study reviews progress of research on risk factors of nosocomial infection among orthopedic patients in recent years.

Teaching research of improving hand hygiene skills among medical students

Objective On the background of the clinical skills competition for national medical students in the higher medical colleges and universities, to investigate medical students' mastery of hand hygiene knowledge and skills, explore the effective methods of teaching, and improve the medical students' hand hygiene compliance and accuracy in clinical practice. Methods 90 medical students at a tertiarylevel teaching hospital clinical practice stage were randomly selected for the study, and performed hand hygiene theoretical knowledge and practical skills training in special education. Special teaching investigation was made before and after training, to investigate the students' hand hygiene compliance rate in clinical practice. And the correct rate of hand hygiene were examined and medical students' hand hygiene compliance rate and correct rate were compared before and after the special teaching and training. Statistical analysis was made by using chi square test 2. Results After theory teaching and additional special skills training the students' hand hygiene compliance and accuracy were improved significantly (79.00% vs. 35.50%, P=0.000). The correct rate of hand hygiene was also significantly higher than before training (92.22% vs. 61.11%, P=0.000). Conclusion Hand hygiene knowledge and skills training can significantly improve the medical students' hand hygiene compliance and accuracy in the clinical practice, and is conducive to the prevention of the spread of infection in hospitals, and then reduce the incidence of hospital infection. Key words: \versities; Hand hygiene; Healthcare-associated infection; Medical students; Special skills training

The significance of multi-criteria decision analysis for the bundle treatment of severe pneumonia

To determine the effect of multi-criteria decision analysis (MCDA) on the effect of bundle treatment for severe pneumonia. A prospective historical control observation was conducted. Seventy-five patients with severe pneumonia having received MCDA (from January 2013 to August 2014) were assigned as intervention group. MCDA group was set up by the medical staff. Bundled treatment plan was composed of the MCDA evaluation results, anti-infection, phlegm and other conventional treatment measures which was adjust on time until the patient was transferred out of the respiratory intensive care unit (RICU) or died. Seventy patients with severe pneumonia before receiving MCDA (from August 2010 to December 2012) were set as historical control group. Comparison of general condition before treatment and the incidence of hospital infection, average hospitalization cost, duration of RICU stay and mortality between these two groups were performed. There were no statistically significant differences in gender, age, past history, and acute physiology and chronic health evaluation II (APACHE II) score at admission between two groups. Compared with control group, the incidence of hospital infection [1.33% (1/75) vs. 11.43% (8/70), χ2 = 4.723, P = 0.030], mean hospitalization cost in RICU (10 thousand Yuan: 3.44 ± 0.79 vs. 3.76 ± 0.91, t = 2.265, P = 0.025), length of RICU stay (days: 15.01 ± 4.22 vs. 16.92 ± 4.79, t = 2.552, P = 0.012) and mortality in RICU [8.0% (6/75) vs. 21.4% (15/70 ), χ2 = 5.272, P = 0.032] in intervention group was significantly decreased. Application of MCDA in the bundle treatment of severe pneumonia could elevate the scientificalness of decision, and reduce the medical cost. Additionally, MCDA is worth to be generalized because the implementation of guidelines can improve the clinical outcome and prognosis of the patients.

Risks analysis and nursing of nosocomial infection in severe drug rush patients

Objective To analyze risk factors related to nosocomial infection in severe drug rash patients, in order to take nursing countermeasures to reduce the incidence of nosocomial infection in the future during nursing work. Methods A total of 158 severe drug rash patients hospitalized in Dermatological Department the First Affiliated Hospital of Wenzhou Medical University from January 2012 to March 2014 and were selected for the retrospection of general information, clinical treatments condition and analyzed with statistical methods. Results A total 18 of 158 severe drug rash patients were infected during hospitalized with infection rate of 11.4%. Albumin levels, ulcer of skin mucous membrane, invasive operation, and diabetes were related risk factors to cause hospital infection (P 0.05). With logistic regression analysis, albumin levels less than 30g/L, ulcer of skin mucous membrane, invasive operation, and diabetes were severe drug rash patients′ independent risk factors to hospital infection (P<0.01). Conclusions Severe drug rash patients have multiple risk factors to hospital infection, so the countermeasures should be taking in clinical in order to decline the incidence of hospital infections. Key words: Hospital infection; Risk factor; Nursing; Severe drug rash

Correlative factors of hospital infection in infants

Objective To lower the incidence of hospital infection analyzing the correlative factors of hospital infection in infants.Methods The incidence of hospital infection,onset age,infection site,hospital stay,and infected by which flora of 1103 infants with hospital infection admitted into our hospital from 2066 to 2012 were retrospectively and statistically analyzed.Results The incidence of hospital infection in infants was 4.17％ in the recent 6 years and was getting down year by year.The incidence was higher in 1-12 months age group than in 1-3 years age group,with a statistical difference(P ＜ 0.05).The most common infection sites were respiratory tract,gastrointestinal tract,skin,and soft tissue.34.28％ were infected by bacteria,28.12％ by fungus,and 19.80％ by zymad.The incidence of hospital infection increased with hospital stay,with a statistical difference (P ＜ 0.05).Conclusions Infant' s age,their own factors,environmental factors,and prolonged hospital stays can increase the incidence of hospital infection.Hospital infection should be controlled pointedly. Key words: Infant; Hospital infection; Infection site; Hospital stay

Hospital infections in a neurological intensive care unit: incidence, causative agents and risk factors

Hospital infections (HIs), which are frequently associated with hospital treatment, increase morbidity, mortality and treatment costs. The aim of this study was to establish the incidence of HIs in a neurological intensive care unit (nICU), and to determine the most prevalent causative agents and risk factors for HIs. A cross-sectional study with nested case-control design was conducted between 1 July 2009 and 30 June 2010 at an 18-bed neurological intensive care unit at the Clinical Center Kragujevac, Serbia. In total, 537 patients were enrolled in the study, with 6,549 patient-days. There were 89 patients with 101 HIs. The incidence of patients with HIs was 16.57%, and incidence of HIs was 18.81%, while density of HIs was 15.42 per 1,000 patient-days. The most frequent anatomical sites of HIs were urinary tract (73.27%), blood (10.89%), and skin and soft tissues (10.89%). The following risk factors were identified: co-morbidity (OR=3.9; 95% CI=1.9-7.9), surgical intervention in the last 30 days (OR=5.6; 95% CI=1.5-20.4), urinary bladder catheterization longer than seven days (OR=3.8; 95% CI=1.8-8.2), value of Glasgow coma scale ≤ 9 (OR=3.7; 95% CI=1-6.9), and longer hospital stay (OR=1.1; 95% CI=1.1-1.2). Hospitalization in an nICU bears high risk of HIs, especially of urinary tract infections caused by Gram-negative bacteria, in patients with longer hospital stay or co-morbidities, and in those who have had surgical interventions or prolonged use of a urinary bladder catheter. Special attention should be paid to these patients to prevent HIs.