Incidence Rate Of Nosocomial Infections Research Articles

Seasonal characteristics of nosocomial infection in a psychiatric hospital in China with different nosocomial prevention and control backgrounds: a retrospective study

This study aimed to investigate the relationship between various prevention and control measures for nosocomial infections (NIs) in psychiatric hospitals and patients with mental disorders. This study aimed to determine the characteristics of NIs in psychiatric hospitals and provide a reference for infection prevention and control in this setting. Data from the NI monitoring system of a psychiatric hospital in southeastern China were analysed. Patients who were hospitalized for mental disorders from January 1, 2016, to November 30, 2019, were classified into the non-COVID-19 containment group (NC19C group, n = 898), while those who were hospitalized from January 25, 2020, to November 30, 2022, were classified into the COVID-19 containment group (C19C group, n = 840). The data were analysed using SPSS version 22.0, and independent sample t tests, chi-square tests, correlation analyses, and multivariate logistic regression analyses were performed. A significance level of P < 0.0024 was applied. The incidence rate of NIs was higher in autumn in the NC19C group, while no seasonal difference was detected in the C19C group (P < 0.0024). Further analysis revealed that in the C19C group, the risk of hospitalized patients with mental disorders developing hospital-acquired pneumonia in spring was 0.362 times that in winter (OR = 0.362, 95% CI = 0.200 ~ 0.656, P = 0.001), and in summer, the risk was 0.342 times that in winter (OR = 0.342, 95% CI = 0.185 ~ 0.633 P = 0.001). Patients aged 18–44 years had a 4.260 times higher risk of developing hospital-acquired upper respiratory tract infections than did those aged 60 years and older (OR = 4.260, 95% CI = 2.143 ~ 8.470; P = 0.000). The risk of acquiring urinary tract infections in the hospital was 0.324 times greater among patients aged 18–44 years than for patients aged 60 years and older (OR = 0.324, 95% CI = 0.171–0.613; P = 0.001). The NC19C group did not exhibit the aforementioned differences. During the NC19C period, differences were observed in the diagnosis of hospital-acquired infections and sex (all P = 0.000). Psychiatric hospitals exhibit distinct nosocomial infection characteristics under the context of various infection control measures. Against the backdrop of strengthened infection control, the nosocomial infection characteristics of psychiatric hospitals may be associated with the features of mental disorders.

Optimization of Monitoring of Nosocomial Infections in Hospitals of the Republic of North Ossetia–Alania

Introduction: Optimization of epidemiological and microbiological monitoring of nosocomial infections at the regional level will contribute to limiting circulation and spread of pathogens and improving preventive measures on the territory of the Russian Federation. Objective: To determine directions of optimization of epidemiological and microbiological monitoring of healthcare-associated infections in surgery departments and intensive care units of hospitals of the Republic of North Ossetia – Alania. Materials and methods: We carried out a retrospective epidemiological analysis of the incidence of nosocomial infections and results of microbiological monitoring conducted in surgery departments and intensive care units of ten multidisciplinary hospitals of the Republic of North Ossetia – Alania in 2015–2019. We also examined data on evaluation of preventive measures, infection control, and compliance with criteria of internal quality control and safety in health care. Results: According to the results of routine surveillance and specially organized epidemiological and microbiological monitoring, the incidence rates of healthcare-associated infections were 0.85 and 26.4 per 1,000 inpatients in surgery departments and intensive care units of hospitals of the Republic of North Ossetia – Alania, respectively. The incidence rates of certain types of nosocomial infections were statistically different (p ≤ 0.05) depending on the type of monitoring (routine/optimized): surgical site infections – 15.9/132.8 per 1,000 surgeries, catheter-associated urinary tract infections – 8.5/69.4 per 1,000 catheter days, central line-associated bloodstream infections – 7.74/89.12 per 1,000 catheter days, and ventilator-associated pneumonia – 8.12/39.74 per 1,000 ventilator days. K. pneumoniae strains isolated from surgery and intensive care patients and exhibiting extreme resistance to antimicrobial drugs belong to sequence type 1082, possess a high pandemic potential, and are widespread in many countries. According to the results of assessing compliance with the criteria of internal quality control and safety of health care, only three of ten hospitals in the Republic of North Ossetia – Alania had the compliance rate ≥ 70 %. As for the readiness for infection prevention and control in surgery departments and intensive care units, 60 % of the hospitals demonstrated a basic level and 40 % – an intermediate level of measures taken. Conclusions: Optimization of approaches to tracing healthcare-associated infections in the hospitals of the Republic of North Ossetia – Alania helped establish that actual incidence rates of nosocomial infections were on the average 26.4 times higher than those officially registered based on the results of routine surveillance.

Determinants That Influence on Infection in Sectio Caesarea Patients at Hermina Bekasi Hospital Period 2021-2022

Nosocomial infections are the leading cause of the world's high rates of morbidity and death. In 2002 the CDC estimated the incidence rate of nosocomial infections in hospitals at approximately 1.7 million people and about 99,000 people dying from these infections. Surgical area infection (IDO) is one of the most nosocomial infections that occurs in hospitals. The use of appropriate prophylactic antibiotics can reduce the incidence of surgical wound infections. In 2014 WHO survey showed that the incidence of surgical area infection (IDO) increased by 1.2 cases per 100 surgical procedures to 23.6 cases per 100 surgical procedures. One of the infections included in the Health Care Associated Infections (HAIs) group is surgical area infections (IDO). The study aims to determine the determinants that affect the incidence of infection in caesarean section patients in hospitals through several determinants studied, namely age, gestational age, maternal parity, comorbidities, maternal health conditions (Hb value), antibiotic type, time of administration, duration of use, route of administration, type of surgery, duration of surgery and Length Of Stay (LOS) with the incidence of IDO in Sectio Caesarea (SC) patients at Hermina Bekasi Hospital for the 2021-2022 period. The design of the retrospective observational study research was carried out with a sample of 350 people. Data were obtained through the Medical Record File (BRM), observation from the time the patient finished SC treatment until control 7 days after treatment at the polyclinic. Data analysis includes univariate analysis, bivariate analysis using quadratic kai test and multivariate analysis with multiple logistic regression non-parametric tests. The results showed that there was an influence between comorbidities (OR = 3,886; 95% CI = 0.948 _ 15,925) and the incidence of IDO. Other factors did not have a significant influence on the incidence of IDO. The results of the double logistic regression non-parametric test found comorbidities to be the most dominant determinant of IDO events. Identification of IDO risk factors can be useful for planning efforts to minimize the incidence of IDO in post-cesarean patients. The use of an improper type of prophylactic antibiotic (ceftriaxone injection) shows an IDO incidence of 0.85% with an effective and efficient cost to be considered to the management of Hermina Bekasi Hospital.

Incidence and determinants of nosocomial infection among hospital admitted adult chronic disease patients in University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia, 2016-2020.

Nosocomial infections are major public health problem which affects more than 100 million patients each year globally. This leads to prolonged hospital stays, a high mortality rate, and a vast financial burden to the healthcare system as well as the patients. This study aimed to find out the incidence of nosocomial infections and determinant factors among admitted adult chronic illness patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. An institutional-based retrospective follow-up study design was employed among 597 respondents. The secondary data was collected from April 15 to May 15, 2021. A computer-generated random sampling technique was used to select a total of 599 patients using Open-epi software. Structured checklists were used to collect data. For data entry and analysis Epi-Data version 4.6 and STATA 16 were used respectively. To identify statistically significant variables Cox-regressions (univariable and multivariable) were performed. To declare statistically significant variables based on p < 0.05 in the multivariable Cox-regression model, adjusted hazard ratio with 95% CI was used. A total of 597(99.6%) adult chronic illness patients were included in the study. Of these, 53 (8.88%) participants developed nosocomial infections and the incidence rate of nosocomial infection was 6.6 per 1,000 person-days observation. In this study, not taking antibiotics (AHR = 2.74, 95% CI: 1.49, 5.04), using mechanical ventilation (AHR = 2.67, 95% CI: 1.36, 5.26), being on urinary catheter (AHR = 4.62, 95% CI: 2.22, 9.65), being on intravenous catheter (AHR = 3.42, 95% CI: 1.22, 9.61) and length of hospital stay >20 days (AHR = 2.66, 95% CI: 1.43, 4.94) were significantly associated with nosocomial infections. The findings have indicated that the incidence of nosocomial infection was low. No taking antibiotics, intravenous insertion, mechanical ventilation, length of hospital stay, and urinary catheterization were the predictors for the development of nosocomial infection. Therefore, we recommend that the healthcare providers need to give emphasis on infection prevention and control in the institution on these factors that have a significant effect on nosocomial infection.

Results of Epidemiological and Microbiological Monitoring of Healthcare- Associated Infections in the Republic of North Ossetia–Alania

Introduction: The complex of exogenous and endogenous risk factors in multidisciplinary hospitals creates conditions for the development of nosocomial infections induced by ESKAPE pathogens. Objective: To establish epidemiological features and etiological significance of antibiotic resistant strains of the leading pathogens inducing hospital-acquired infections and to determine their prevalence in multidisciplinary clinics of the Republic of North Ossetia–Alania. Materials and methods: We analyzed the incidence of nosocomial infections and results of the microbiological monitoring of antimicrobial drug resistance in leading pathogens for the years 2012–2021. Detection of genes encoding the production of metallo-β-lactamases was performed in P. aeruginosa strains, extended-spectrum β-lactamases and PFGE profiles of E. coli and K. pneumoniae strains. Results: In the Republic of North Ossetia–Alania, the average long-term incidence rate of hospital-acquired infections in the study period was 0.74 per 1,000 inpatients. We established that 44.2 % of all such cases were diagnosed in surgical departments, 32.4 % – in maternity departments, 6.6 % – in pediatric departments, and 16.8 % – in other clinical departments. The average long-term incidence rate of nosocomial infections was the highest (0.85 per 1,000 patients) in departments of surgery, the most prevalent being surgical and injection site infections, lower respiratory tract and urinary tract infections. The leading pathogens in the etiological structure were Enterobacteriaceae spp., P. aeruginosa and Staphylococcus spp. The incidence rates estimated based on microbiological monitoring results were on average 2.5 times higher than those registered within the routine surveillance system. Conclusions: Incidence rates of healthcare-associated infections in the Republic of North Ossetia–Alania are comparable to those in the Russian Federation. Patients of surgery departments are at higher risk for nosocomial infections. Optimization of preventive measures requires a risk-based approach that takes into account in-depth microbiological monitoring data on the most common pathogens resistant to drugs of choice in local hospitals.

Effects of Family Participatory Nursing on Clinical Outcomes of Premature Infants in NICU and Families' Psychological Status.

The purpose of this study was to explore the effects of family participatory nursing on the clinical outcomes of premature infants in the neonatal intensive care unit (NICU) and their families' psychological status. Total of 150 premature infants were admitted to the NICU of our hospital from December 2019 to December 2021, and their families were selected by convenience sampling method and divided into control group (n = 78, from December 2019 to December 2020) and observation group (n = 72, from January 2020 to December 2021) according to the admission time. The infants in the control group were given routine nursing, while those in the observation group received family participatory nursing. In the observation group, the length of stay and duration of oxygen therapy were shorter, the weight gain speed was higher, and the incidence rate of nosocomial infection was lower than those in control groups (P < 0.05). The time of reaching full gastrointestinal feeding was earlier, the daily milk intake and exclusive breastfeeding rate were higher, and the feeding intolerance rate was lower in observation group than those in control group (P < 0.05). Observation group exhibited significantly higher body weight, Z-value of body weight, NBNA score at 7 d after hospitalization, 15-month mental development index (MDI), and psychomotor development index (PDI) scores than control group (P < 0.05). In addition, the families' somatization, depression and anxiety factor scores, and total score of SCL-90 in the observation group were lower than those in the control group, while each dimension score and total score of MPOC-20 were higher than those in control groups (P < 0.05). Family participatory nursing is of great significance in ameliorating the clinical outcomes of premature infants in the NICU, which can shorten the length of stay, improve feeding conditions, facilitate infant growth and development, and enhance their families' psychological status and nursing satisfaction.

Aparelho celular: risco de infecções hospitalares durante jornada de trabalho de profissionais da saúde

Objetivo: Discutir medidas de prevenção de antissepsia em aparelhos celulares constantemente utilizados em blocos cirúrgicos e associar a adesão de protocolos rígidos de higienização das mãos em ambientes hospitalares restritos. Métodos: Trata-se de um estudo exploratório, descritivo, do tipo revisão narrativa da literatura, para coleta de dados, foram utilizadas as bibliotecas virtuais de pesquisa: Google Acadêmico, Advensad Biomedical Research, Saber digital, Hospital Santa Cruz (HSC). Resultados: Nos resultados desta pesquisa foram usados 12 artigos científicos, 2 revistas eletrônicas e 1 decreto de lei, que apontaram que o aparelho telefônico é um recurso utilizado habitualmente e diariamente por todos, pode ainda apresentar-se como ponte que liga a transmissão de bactérias as infecções nos ambientes hospitalares. Além disso, esta tecnologia torna-se um veículo para microrganismos infecciosos, e sua utilização durante a prestação do serviço de saúde pode elevar a taxa de incidência de infecções hospitalares. Considerações finais: Portanto, implementar protocolos de higienização dos parelhos celulares e seguir medidas de educação continuada adotando novas metodologias de trabalho, assim assegurando a segurança do paciente.

Effect of Nursing Workload in Intensive Care Units.

Nursing work efforts are important in providing sound healthcare services, especially in the intensive care units (ICU). Complications and adverse events are more liable to occur among patients in the ICU and these patients require more attention and nursing care. Most of the research in this field is mainly focused on the effect of staffing and its correlation to patient safety and satisfaction. Previous studies also showed that reduced nursing staffing was significantly associated with the development of pneumonia in ICU patients who needed more nursing requirements. An increase in nursing workload is also significantly associated with an increased incidence rate of nosocomial infections. The association between nursing workload in ICU patients and increased incidence rates of mortality is also supported by previous studies. The nurse-to-patient ratio has been previously used to evaluate patient safety correlation with the nursing workload as reported by previous reports. However, previous research shows that the nursing workload is a more complex correlation and can not be determined by a simple ratio as the nurse-to-patient one. Evidence shows that many adverse events may occur with patients in the ICU secondary to reduced nursing care such as increased mortality, length of hospital stay, and catching in-hospital infections. In the current study, we aim to review the outcomes from previous investigations to further emphasize the effect of nursing workload on ICU patient outcomes and safety.

Risk factors of nosocomial infection in pediatric ward in a hospital

Objective To analyze the risk factors of nosocomial infection in the pediatric ward in a hospital and nursing care for relevant prevention and control. Methods Totally 1 460 pediatric inpatients admitted in Taizhou First People's Hospital from June 2017 to January 2019 were retrospectively analyzed and divided into the infection group and the control group according to the existence of infection. The children's medical records were organized; the risk factors of nosocomial infection in pediatric inpatients were analyzed; and relevant nursing measures were summarized. Results Nosocomial infection was found in 89 out of the 1 460 children; most children were found with respiratory tract infection and digestive canal infection in the infected children, which accounted for 36 cases (40.4%) and 23 cases (25.8%) , respectively; the proportion of children aged 10 days, with malnutrition, invasive operation, receiving antibiotics for >10 days, or receiving immunosuppressors or unqualified sterile operation in the infection group was higher than that in the control group, and there was statistically significant difference between the two groups (P 10 days, invasive operation, use of antibiotics for >10 days, use of immunosuppressors and unqualified sterile operation. Conclusions Pediatric inpatients are prone to nosocomial infection, and the type of infection is mainly respiratory tract infection and digestive canal infection. Relevant nursing measures should be taken based on the factors of infection in order to reduce the incidence rate of nosocomial infection in children. Key words: Nursing care; Pediatrics; Hospitalization; Nosocomial infection; Risk factor

Analysis of the Influence of Operating Room Nursing Care Management on the Incidence Rate of Nosocomial Infection in Orthopedic Surgery Patients

Abstract: Objective: To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients. Methodology: Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups, which were the control group (under general management) and the observation group (under the operating room nursing care management). Further, the incidence rate of nosocomial infections, the incidence rate of irregular nursing care phenomena, the satisfaction score of nursing care management, and the quality of life score were observed and recorded. Result: The incidence rate of nosocomial infection, the incidence rate of irregular nursing care management, the satisfaction score of nursing care management, and the quality of life score of the observation group were compared to that of the control group, and the result showed P&lt;0.05, indicates the statistical significance between the data indicators. Conclusion: The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.

Nosocomial infections in the Intensive Care Unit: annual incidence rate and clinical aspects

Bien que les réanimations ne comprennent en général qu’une faible proportion des lits hospitaliers; elles constituent la scène d’une forte proportion des infections nosocomiales La gestion du risque infectieux en réanimation constitue aujourd’hui une priorité; l’un des axes stratégiques prioritaires est la mise en place d’un système de surveillance épidémiologique. Nos objectifs étaient de déterminer l’incidence et les Aspects Cliniques afin d’identifier les facteurs de risque. Il s’agit d’une étude descriptive longitudinale d’incidence incluant les patients ayant dépassés 48 heures dans le service de réanimation polyvalente à l’hôpital Ibn El Jazzar de Kairouan sur une période d’une année allant de 01/03/2013 jusqu’au 28/02/2014. L’enquête a porté sur 265 patients dont l’âge moyen était 39±20 ans (18 à 93 ans) et le sexe ratio (H/F) a été de 2,48. Nous avons identifié 125 épisodes d’infections nosocomiales chez 81 malades soit une incidence de 30,6%. La densité d’incidence était de 55 infections pour 1000 jours d’hospitalisation. On a notifié une nette prédominance des pneumopathies avec une incidence de 27,73%, suivies des infections urinaires de 9,73%, des infections liées au cathétérisme veineux central 6,25% et des infections du site opératoire de 2,34%. Le taux de mortalité parmi les enquêtés a été de 28,7% avec une différence significative entre les patients infectés (44,7% des cas) et ceux non infectés (29,07%) (p < 10-3). Les microorganismes étaient des BGN dans 80% des cas. La prévention ne peut se concevoir que sous la forme d’une action globale et multidisciplinaire.

Effects of an antimicrobial restriction system on appropriate carbapenem use in a hospital without infectious diseases consultation.

BackgroundGram-negative bacteria are becoming increasingly resistant to carbapenems and are related to the use of carbapenems. Thus, the main objective of this study was to compare the appropriateness of prescribing carbapenem before and after using an antimicrobial restriction system without infectious diseases consultation.Materials and methodsA retrospective cross-sectional before and after study was conducted in Lamphun Hospital to limit the prescription of carbapenems. Data were obtained by a review of the medical records and electronic databases from the period September 2014 to January 2015 (before) and from September 2015 to January 2016 (after).ResultsA total of 360 antibacterial prescriptions were analyzed. The appropriateness of prescribing was higher after using the antimicrobial restriction (55.0%) than before using the antimicrobial restriction system (38.3%; p=0.001). The amount of carbapenem in the defined daily dose per 1,000 bed days increased by 3.48% after using the antimicrobial restriction system when compared with before using the antimicrobial restriction system, which was not statistically significant (p=0.611). The incidence rates of nosocomial infections caused by resistance of Enterobacteriaceae to ertapenem before and after the intervention to limit antimicrobial therapy was found to have decreased from 4.80 to 0.95 infections per 1,000 patient days, respectively (p=1.00). The expenditure for carbapenems in the average value of baht per patient was found to have decreased by 36.33% after using the antimicrobial restriction system when compared with before using the antimicrobial restriction system (p=0.001).ConclusionThese results suggest that antimicrobial restriction systems can increase the appropriateness of prescribing antibiotics. The expenditure for carbapenem was found to decrease after using the antimicrobial restriction system when compared with before using the antimicrobial restriction system, even without infectious diseases consultation. However, the amount of carbapenem in the defined daily dose per 1,000 bed days was not found to reduce after using the antimicrobial restriction system.

Factors related to the implementation of universal precautions by nurses in the inpatient unit (IRINA F) Prof. Dr. R. D. Kandou Central General Hospital Manado

Nosocomial infection is an infection acquired when someone had ever been in a hospital or other health care facility. The high incidence rates of nosocomial infections indicate low quality of health services in the hospital. In this regard so that the implementation of universal precautions is an action to control against infections by health workers to reduce the infection transmission risk. The aim of this study is to determine factors related to the implementation of universal precautions by nurses in the inpatient unit (IRINA F) Prof. Dr. R. D. Kandou Central General Hospital Manado.Quantitative research design was employed with analytical survey method and by using cross sectional study approach. The study was conducted in the inpatient unit (IRINA F) Prof. Dr. R. D. Kandou Central General Hospital Manado since September – December 2016. Total sampling technique employed to obtain 65 people. Data was collected through validated questionnaires.The result shows a significant relationship between knowledge and the implementation of universal precautions (p &lt; 0,005), but there is no significant relationship between the availability of facilities and motivation with the implementation of universal precautions (p=0,271 and 0.338, respectively). Multiple logistic regression showing that knowledge is the most predominant factor regarding the implementation of universal precautions by nurses.Overall, it can be concluded that there is a significant relationship between knowledge with the implementation of universal precautions by nurses. Thus, various efforts to improve the knowledge of nurses regarding with the implementation of universal precautions are necessary in preventing nosocomial infection.Â

Survey on nosocomial infection knowledge of medical staff in a tertiary hospital of Beijing

Objective To explore the nosocomial infection knowledge of medical staff in tertiary hospitals of Beijing, and identify the influencing factors of nosocomial infection knowledge among medical staff. Methods By random sampling method, 848 medical workers in a tertiary hospital were investigated by the self-designed questionnaire of medical workers′ knowledge about nosocomial infection control questionnaire. Results The average score of medical workers′ knowledge about nosocomial infection control was (68.78±11.70) . The univariate analysis on the influencing factors of nosocomial infection knowledge showed that, the scores of medical workers′ knowledge about nosocomial infection were significantly different among workers in different departments and with different professional titles (t=6.715, 53.166; P<0.05) . Conclusions The medical workers′ knowledge about nosocomial infection in tertiary hospitals is at a medium level. Aimed at the items with low knowledge score in different groups and different medical workers, we should enhance the training among medical workers to reduce the occurrence of nosocomial infection and the incidence rate of nosocomial infection. Key words: Medical staff; Knowledge; Infection control; Status survey; Tertiary hospital

Nosocomial Infection Rates During One Year in Naft Grand Hospital, Ahvaz, Iran

Background: Nosocomial infections have increasingly resulted in death and the patients should bear high treatment costs. Members of the medical team could play an important role in prevention and control of nosocomial infections. Objectives: The purpose of this research was the evaluation of nosocomial infections in patients admitted to Naft grand hospital in Ahvaz, Iran, during 2013. Patients and Methods: This was a descriptive study, conducted prospectively during 12 months from March 2013 to March 2014 in Naft grand hospital in Ahvaz, Iran. All the patients who were hospitalized with no signs and symptoms of infection before the first 48 hours of hospitalization and presenting signs and symptoms of infection after 48 hours of hospitalization were included in this study. The patients’ age, gender, site of infection, ward of hospitalization and type of nosocomial infection were collected. The results were analyzed by Excel and SPSS 16.0. Results: The results of the present study showed that the incidence of nosocomial infections was low (i.e., < 2%). The incidence rates of nosocomial infections were 36.78% in the intensive care unit (ICU), 46.55% in the internal medicine ward, 14.94% in the surgical medicine ward and 1.72% in the coronary care unit (CCU). Regarding the etiology of infection, Escherichia coli was found in 43.10%, coagulase-positive Staphylococci in 17.24%, coagulase-negative Staphylococci in 14.95% and Klebsiella in 10.34% of the cases. In our hospital, E. coli was the most frequent pathogen. Conclusions: In this study, nosocomial infections had a lower frequency in comparison with the national rates. According to researches, hospitals have been able to reduce nosocomial infections by establishing strategies and getting the risks under control.

Nosocomial Infection Rates During One Year in Naft Grand Hospital, Ahvaz, Iran

Background: Nosocomial infections have increasingly resulted in death and the patients should bear high treatment costs. Members of the medical team could play an important role in prevention and control of nosocomial infections. Objectives: The purpose of this research was the evaluation of nosocomial infections in patients admitted to Naft grand hospital in Ahvaz, Iran, during 2013. Patients and Methods: This was a descriptive study, conducted prospectively during 12 months from March 2013 to March 2014 in Naft grand hospital in Ahvaz, Iran. All the patients who were hospitalized with no signs and symptoms of infection before the first 48 hours of hospitalization and presenting signs and symptoms of infection after 48 hours of hospitalization were included in this study. The patients’ age, gender, site of infection, ward of hospitalization and type of nosocomial infection were collected. The results were analyzed by Excel and SPSS 16.0. Results: The results of the present study showed that the incidence of nosocomial infections was low (i.e., < 2%). The incidence rates of nosocomial infections were 36.78% in the intensive care unit (ICU), 46.55% in the internal medicine ward, 14.94% in the surgical medicine ward and 1.72% in the coronary care unit (CCU). Regarding the etiology of infection, Escherichia coli was found in 43.10%, coagulase-positive Staphylococci in 17.24%, coagulase-negative Staphylococci in 14.95% and Klebsiella in 10.34% of the cases. In our hospital, E. coli was the most frequent pathogen. Conclusions: In this study, nosocomial infections had a lower frequency in comparison with the national rates. According to researches, hospitals have been able to reduce nosocomial infections by establishing strategies and getting the risks under control.

The Study of Nosocomial Infections in Neonatal Intensive Care Unit, A prospective study in Northwest Iran

Background: Nosocomial infections are an important cause of mortality in neonatal intensive care units (NICUs). Therefore, in this study, the incidence and prevalence of nosocomial infections were determined in NICUs of the three largest neonatal centers in northwest Iran, and the causative bacteria were identified in order to provide potential solutions to control the infections in these hospitals. Materials and Methods: This is a descriptive-prospective study in which the cases of nosocomial infections were examined in the three largest hospitals in Tabriz city in northwest Iran, during one year (from June 2012 to May 2013) based on clinical findings, medical and nursing reports of patients, and laboratory results. Results: Of the 3129 patients hospitalized in NICUs of the three hospitals, 208 patients were diagnosed with nosocomial infections. The incidence rate of nosocomial infections was 11.34% (per 100 patientdays) with: 52.4% bacteremia, 32.69% pneumonia, 5.77% urinary tract infections, 5.29% wound infections, and 3.85% necrotizing enterocolitis. There was a statistically significant relationship between invasive procedures (such as umbilical catheters, central venous catheters, surgery, and TPN) and sepsis (P=0.001).The relationships between urinary tract infection and urinary catheter (P=0.000), and aggressive procedures (such as suctioning and intubation) and pneumonia (P=0.001) were also statistically significant. Conclusion: Incidence of nosocomial infections in premature and low birth weight newborns is considered as a health threat. The findings of this research reiterate the importance of giving further attention to prevention and control of nosocomial infections in the NICU.

Study on the application effect of development care on promoting the maturity of gastrointestinal and ;immunologic function in the premature infants

Objective To explore the effect of development care on promoting the maturity of gastrointestinal and immunologic function in the premature infants .Methods One hundred premature infants were randomly divided into the conventional group and the experimental group according to the random number table, each with 50 cases.The two groups received the routine nursing measures , and the conventional group received the non-nutritive sucking during the non-oral feeding period , while the experimental group received development care .The levels of gastrin （ GAS） , IgG and IgM were compared between two groups , and the time required for recovery of birth weight and the incidence rate of nosocomial infection were also compared . Results No difference was found in the level of blood GAS at the birth （P＆gt;0.05）.The level of GAS in the conventional group was （115.59 ±25.87） ng/L five days after the birth, and was lower than （138.52 ± 26.62）ng/L in the experimental group, and the difference was statistically significant （t=4.37, P＆lt;0.01）. The levels of IgG and IgM in the conventional group were respectively （83.56 ±21.17） and （1.54 ±0.62）Ug/ml ten days after the birth, and were respectively （91.19 ±21.29） and （1.78 ±0.62） Ug/ml in the experimental group, and the difference was not statistically significant （t =1.80, 1.93, respectively; P〈0.05）.The time required for recovery of birth weight in the experimental group was （9.12 ±2.1） d, and was less than （12.00 ±2.12） d in the conventional group , and the difference was statistically significant （ t =6.68, P〈0.05）.The incidence rate of nosocomial infection was 0.98‰ in the experimental group, and was 3.94‰ in the conventional group, and there was no statistically significant difference （χ2 =0.84, P 〈0.05 ）. Conclusions Development care can promote the release of gastrointestinal hormones in premature infants , and also promote the maturity of gastrointestinal function and the increase in weight growth , and has no obvious role in promoting the maturity of immunologic function . Key words: Premature infants; Developmental care; Gastrin; Humoral immunity; Nosocomial infection

Epidemiological and bacteriological profiles in children with burns

ObjectivesThe aim of our study is to determine the most prevalent bacteria responsible for nosocomial infection (NI) in burned children. Materials and methodsA prospective analytic study was conducted over a period of 30 months at the Children's Hospital of Tunisia. All burned children were enrolled. ResultsA total of 185 children were hospitalised during the study period. The mean age was 30 months (interquartile range, IR:18; 48). The gender ratio of the study population was 1.3 (104 males and 81 females). The mean total body surface area burned (TBSA) was 10% (IR:6; 16). The incidence rate of NI was 39.1 NIs per 1000 patient-days and two-thirds of the infections were polymicrobial. The most common isolated micro-organisms were methicillin-susceptible Staphylococcus aureus (MSSA, 57.7%), wild-type Pseudomonas aeruginosa (35.9%) and wild-type Enterobacter cloacae (26.9%). The case fatality rate was 5.9% corresponding to a crude death rate of 1.32 deaths per year. Septic shock with multiple organ failure was the leading cause of death. ConclusionThe most common micro-organisms responsible for NI in our series were of the wild-type phenotype. Thus, on suspicion of sepsis, empiric antibiotic treatment combining piperacillin, oxacillin and gentamicin can be proposed until identification of the causative microorganism is available.

Environmental control and nosocomial infections in pediatric intensive care unit

Nosocomial infections take a tremendous impact to patients and curative activities in PICU.The occuring and developing of nosocomial infections are in close relation to the different internal and external environments of the patients.The incidence rate of nosocomial infections can be effectively reduced by the control of environmental factors in timely and reasonably.This paper reviewed the related internal and external environment factors and control measures in PICU nosocomial infections. Key words: Nosocomial infection; Intensive care unit; Pediatrics; Environment; Prevention and control