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Objective To investigate the characteristics and risk factors of infection after liver transplantation from donor liver of donation after citizen's death. Methods Clinical data of 68 recipients after liver transplantation from donor liver of donation after citizen's death were analyzed retrospectively. The recipients were divided into infection group (33 cases) and non-infection group (35 cases) according to the presence of infection after operation. Major infection characteristics of the 68 recipients after liver transplantation were summarized. Univariate analysis was conducted on the possible risk factors of infection after liver transplantation, and multivariate analysis was further conducted on the risk factors with statistical significance, so as to find out the independent risk factors. In addition, accuracy of predicting infection after liver transplantation was analyzed using receiver operating characteristic (ROC) curves. Results Thirty-three recipients were infected after liver transplantation, accounting for 49% of the total recipients with bacterial infection and fungal infection mainly. These recipients mainly presented pulmonary infection and abdominal cavity infection. Univariate analysis results showed that a total of 8 factors contributed to infection after liver transplantation from donor liver of organ donation, including the donors' open injury, recipients' preoperative hemoglobin level, platelet count, Child-Pugh classification of liver function, model for end-stage liver disease (MELD) score, intraoperative erythrocyte infusion, gamma-glutamyl transpeptidase (GGT) on day 1 after operation and postoperative stay time of intensive care unit (ICU) (all P<0.05). Multivariate Logistic regression results analysis showed that preoperative hemoglobin level <120 g/L and postoperative stay time of ICU >96 h were the independent risk factors of infection after liver transplantation from donor liver of organ donation (both P<0.05). Analysis results of ROC curves showed that preoperative hemoglobin level<114 g/L and postoperative stay time of ICU >102 h resulted in higher accuracy for predicting postoperative infection. Conclusions Infection after liver transplantation from donation after citizen's death presents high incidence, dominated by bacterial infection and fungal infection in lung and abdominal cavity. Low preoperative hemoglobin level and long postoperative stay time of ICU of recipients can increase the risk of infection after liver transplantation.
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Objective To investigate the healthcare-associated infection(HAI) status, common infection sites, and antimicrobial use in a county hospital in 2011-2015.Methods With combination of bedside survey and case history reviewing, HAI among all hospitalized patients at 0:00-24:00 on April 26, 2011, April 25, 2012, May 14, 2013, September 9, 2014, and August 12, 2015 were surveyed, survey data were analyzed by software SPSS17.0.Results A total of 5 165 patients participated in 5 surveys of HAI prevalence rate, 132 patients had 138 cases of HAI, prevalence rate and case prevalence rate were 2.56％ and 2.67％ respectively.Intensive care unit had the highest average HAI prevalence rate(22.58％).Lower respiratory tract was the main HAI site (58.70％), followed by urinary tract (12.32％), upper respiratory tract (10.14％), and skin soft tissue(5.07％).A total of 45 strains of pathogens were isolated, mainly gram-negative bacteria (n=30, 66.67％).The total usage rate of antimicrobial agents was 45.27％, in 5 prevalence surveys were 61.48％, 43.89％, 37.81％, 39.43％, and 44.79％ respectively.The main purpose of antimicrobial use was therapy (including therapy + prevention), accounting for 78.27％;monotherapy accounted for 81.27％.Conclusion Through prevalence rate survey for 5 consecutive years, HAI management departments can be more comprehensively understand HAI in key departments, key patients, key sites of HAI, and antimicrobial use in this hospital, and provide basis for the formulation and implementation of HAI prevention and control measures according to the actual situation of the hospital.
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Sepsis is the most common cause of death in infants and children in the world.Common infection sites leading to sepsis include respiratory tract,bloodstream,urinary tract,alimentary tract,central nervous system,and endocardia.Infection site is hypothesized to have the significant susceptibility.There is little epidemiological or national research data on the site of sepsis in China.In this article,we discussed the susceptibility of infection site in sepsis by literature review.Identifying infection site early would help guide clinical decision making in diagnosis, treatment and prognosis.
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Objective To understand the prevalence and risk factors of healthcare-associated infection(HAD,and provide evidence for prevention and control of HAI.Methods A cross-sectional survey was adopted,bedside survey and medical record reviewing method was combined to investigate and analyze the prevalence of HAI in a tertiary first-class hospital in 2012-2015.Results A total of 4 725 hospitalized patients were surveyed,the prevalence rates in 2012-2015 were 6.00％,4.77％,3.93％,and 3.05％ respectively,difference was significant(P＜0.05);antimicrobial usage rates were 30.56％,33.82％,32.84％,and 34.48％ respectively,difference was not significant (P＞0.05);the main infection site was lower respiratory tract (43.00 ％),followed by surgical site (16.43 ％);the risk factors for HAI were age ≥65 years,chronic systemic diseases(diabetes,cirrhosis,chronic renal failure,chronic lung disease),immunodeficiency(white blood cell＜1.5 × 109/L),coma,tracheotomy,and mechanical ventilation.Conclusion Survey on HAI prevalence can promote continuous improvement of HAI management,surveillance on surgical site infection and risk factors of HAI should be strengthened.
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Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.
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Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.
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Objective To analyze the infection sites of pseudomonas aeruginosa (PAE) isolated from patients in hospital ,and in‐vestigate their drug resistance situation ,in order to provide reference information for clinical use of antibiotics rationally .Methods The sample distribution of PAE between January 2012 and December 2013 were retrospectively analyzed .And the resistance rates of PAE to antibacterial drugs from different sites of patients were statistically compared .Results The isolation rate of PAE in re‐spiratory tract was the highest ,accounting for 74 .1% ,closely followed by isolation rate in urine and wound secretion .The resist‐ance rate of PAE to antibacterial drugs in these three kinds of specimen is statistically different (P<0 .05) .The resistance rate of PAE is high in respiratory tract ,and low in wound secretion .Conclusion The pseudomonas aeruginosa infection is mostly common‐ly found in respiratory tract ,and has the highest drug resistance rate .The choice of antibacterial drug should be made according to the infection sites of patients ,because the resistance rate of PAE in different sites of patients is significantly different .
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Objective To investigate the relationship between occurrence of healthcare-associated infection (HAI)and seasonal change,so as to provide the basis for seasonal HAI prevention and control.Methods The occurrence of HAI among inpatients in a hospital between 2010 and 2013 was analyzed retrospectively.Results Of 303 371 patients,10 376 developed 12 919 cases of HAI,the incidence of HAI was 3.42%,infection case incidence was 4.26%.The highest inci-dence of HAI occurred in the fourth quarter(3.76%)and lowest in the second quarter (3.20%)(P 5%:intensive care unit(ICU,24.61%),hematology(17.47%),rehabilitation(13.16%),neurosurgery(9.27%),infectious diseases (9.17%),cardiothoracic surgery(7.67%),and hepatobiliary surgery(5.13%),the main HAI sites in patients in ICU,department of neurosurgery were lower respiratory tract,blood stream,and urinary tract.Conclusion The occu-rrence of HAI is closely related with seasonal change,appropriate control measures should be taken according to seasonal change and sites of high HAI rates,so as to reduce the occurrence of HAI.
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Objective To realize the incidence of healthcare-associated infection(HAI)in patients after receiving extracorporeal membrane oxygenation(ECMO)procedure,and to evaluate the related factors for HAI.Methods Clinical data of patients receiving ECMO from January 2003 to December 2012 were collected and analyzed retro-spectively.Results Of 43 patients receiving ECMO,15 (34.88% )developed 24 times(55.81% )of HAI. The main HAI site was lower respiratory tract(n= 12,50.00% ),followed by blood stream(n= 6,25.00% ),skin and soft tis-sue(n= 5,20.83% ).A total of 28 isolates of pathogens were detected,gram-negative bacilli were 19(67.86% )iso-lates,gram-positive cocci 7(25.00% ),and fungi 2(7.14% );pathogens were mainly isolated from specimens of sputum(n= 12,42.86% ),blood (n= 9,32.14% )and wound secretion(n= 6,21 .43% ). The incidence of postopera-tive HAI in ECMO patients was related with patients’age,duration of ECMO,complication,mechanical ventila-tion,tracheal intubation or tracheotomy,and indwelling urinary catheter.Conclusion HAI in patients receiving EC-MO is high,hospital should take corresponding prevention and control measures targeting to the related risk factors of infection,so as to reduce the incidence of HAI after the ECMO.
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Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in a hospital,so as to provide reference for making HAI control measures.Methods The cross-sectional survey on HAI was carried out among all hospitalized patients on May 26,2010,December 12,2012 and December 4,2013,respectively,sur-veyed data were analyzed.Results The prevalence rate was 6.66%(n =116),6.67%(n =113)and 6.33%(n =120)in 2010,2012 and 2013 respectively,and case rate was 7.29%(n=127),7.38%(n=125)and 6.97%(n=132) respectively,intensive care unit(ICU )had the highest infection rate,internal medicine ICU was up to 71 .43%. The main infection site was lower respiratory tract(44.53%),followed by surgical site infection (9.11 %)and uri-nary tract infection (9.11 %).The isolation rate of gram-negative bacteria,gram-positive bacteria and fungi was 60.81 %,20.38% and 18.81 % respectively.Usage rate of antimicrobial agents in three years was 32.95%, 29.87% and 25.59% respectively (χ2 = 13.16,P <0.01 ).Conclusion Prevalence rate of HAI in this hospital is high ,the main pathogen is gram-negative bacteria,the main infection site is lower respiratory tract ,antimicrobial use decreased year by year.Monitor on high risk departments,main sites and pathogens should be intensified.
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Objective To investigate the prevalence rates of healthcare-associated infection(HAI)and antimicrobial use in a maternal and child health hospital,so as to provide reference for preventing and controlling HAI.Methods A cross-sec-tional survey on HAI prevalence of all hospitalized patients from 2010 to 2014 was conducted by combination of bedside ex-amination and medical record review.Results The prevalence rates of HAI in 2010—2014 was 3.29%,5.20%,3.97%, 3.93% and 3.73% respectively.HAI mainly occurred in patients at department of pediatrics (9.09%-12.96%),the major infection site was upper respiratory tract (50.00%-69.56%).Antimicrobial usage rate was 50.19%,41.40%, 23.40%,25.47% and 23.92% respectively,which decreased year by year (χ2 = 133.40,P 95%.Conclusion Antimicrobial a-gents used by hospitalized patients showed a overall downward trend from 2010 to 2014.,but antimicrobial prophylactic us-age rate is high,management of antimicrobial agents should be strengthened.
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OBJECTIVE To promote the direction,administration and surveillance of nosocomial infection control in general hospital,and to prevent the onset of nosocomial infection and reduce its rate.METHODS Retrospective study was taken based on the data of 95193 cases from Jan 2003 to Jan 2007.RESULTS Nosocomial infection happened in 5024 patients and in 5545 cases-times out of 95193 cases,and the rate was 5.28% and 5.83%,respectively.Infection rate(8.49%)in internal medicine were the highest.The main infection site was lower and upper respiratory tract(the constituent ratio 30.66% and 23.20% respectively).CONCLUSIONS Diminishing or avoiding invasive process,using antibacterial drug rationally,promoting the surveillance of the key department and key patients are very important to control nosocomial infection.
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OBJECTIVE To understand the related factors,the situation and dynamics of hospital infection in order to effectively prevent and control it.METHODS From 12306 cases of inpatients who had investigated retrospectively,706 cases were with nosocomial infection monitored from Jan to Dec 2006.RESULTS The hospital infection rate was 5.74% in 2006.The hematological disease and,cancer patients and the elderly,were the high-risk population.The main infection site was the respiratory tract.Fungi accounted for 21.35%,the top was the Candida albicans.CONCLUSIONS To strengthen the training of medical staff,to monitor the key departments of hematology and cancer and respiratory diseases and to attend the disease surveillance and rationally use of antibiotics are the effective measures to reduce hospital-acquired infections.
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OBJECTIVE To understand the status of the hospital infection and risk factors,as well as the existing problems of infection management,to improve the surveillance method of incidence rate of hospital infection and strengthen the infectious precaution and control measures.METHODS By efforts of the professional staff of hospital,with cooperateion of the clinic personnel infection management group,all the patients in hospital were investigated when sampled from zero hour of the day before investigation to the zero hour of the day of investigation,according to the requirement of nosocomial infection rate to design the questionnaire.The data were analyzed.RESULTS The patients investigated in hospital were 638,from them 38 cases with hospital infections were found,the incidence and case-time rates of hospital infection were 6.0% and 7.4%,respectively.Respiratory infection was the most common.CONCLUSIONS Compared with the investigation method used previously,the current approach is easy and standardized.It also provides the credible reference to improve infection surveillance and management.
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OBJECTIVE To give an overview of our hospital′s actual infection situation and to draw attention to infection control,thus improving the weaknesses. METHODS With a method of transversal section,choosing the day of Jun 14 2005,we investigated all this day′s hospitalized patients. RESULTS The result was that the infection rate was 6.6%,mostly contributed by the lower respiratory infection. CONCLUSIONS The incidence of nosocomial infection is connected with following factors such as hospitalized time,age,surrounding contamination,and the long time usage of antibiotics.