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Objective To investigate the occurrence of healthcare-associated infection(HAI)in different weight groups of neonates in neonatal intensive care unit (NICU)and general neonatal wards,and find out the high risk factors for HAI.Methods Targeted monitoring on hospitalized neonates in the neonatal department of a hospital in 2016 and January-November 2017 was prospectively surveyed,HAI rate,device usage rate and device-associated in-fection rate in different weight groups of neonates in NICU and general neonatal wards were compared.Results From 2016 to November 2017,a total of 3 872 neonates were monitored,the total hospitalization days were 42 427 days,56 patients had 62 cases of infection,HAI rate and HAI case rate were 1.45% and 1.60% respectively.HAI rate and HAI case rate in NICU were 5.28% and 6.03% respectively;HAI rate and HAI case rate in general neo-natal wards were both 0.46%,constituent ratio of septicemia ranked first of infection in both NICU and general neonatal wards,accounting for 43.75% and 50.00% respectively,followed by lower respiratory tract(LRT)infec-tion,accounting for 27.08% and 21.43% respectively.HAI rate of different weight groups of neonates in NICU and general wards were both significantly different(χ2＝107.78,46.65,respectively,both P＜0.0001),the lower weight of the neonates,the higher HAI rate;ventilator usage rate in neonates was positively correlated with HAI (r＝0.973,P＝0.027),the higher device usage rate,the higher HAI rate.Fungal septicemia rate per 1 000 days in rainy season was higher than that of non-rainy season (0.53‰ vs 0.37‰).A total of 70 specimens were detected, 45 strains of bacteria and fungi were isolated,pathogens were all from LRT and blood system,Pseudomonas aeru-ginosa was the main pathogen from LRT,Klebsiella pneumoniae and Candida krusei were the main pathogens from blood system.Conclusion Targeted monitoring on neonatal HAI can timely find out high risk factors for neonatal HAI,analyze the causes of infection,formulate corresponding prevention and control measures,reduce HAI rate, and ensure the medical safety of neonates.
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Objective To understand the occurrence of surgical site infection(SSI)following caesarean section,analyze risk factors,implement intervention measures,and evaluate intervention efficacy. Methods All puerperas who underwent caesarean section in the obstetric department of a hospital from January to December 2013 were mo-nitored,investigation were performed in two stages:evaluation stage(January-June,2013)and intervention stage (July-December,2013). Targeted intervention and clinical intervention were combined to intervene the risk factors. Occurrence of SSI,length of hospital stay,and hospitalization expense before and after intervention were compared. Results A total of 1 593 patients with caesarean section were monitored,31(1.95%)had SSI,incidence of SSI in evaluation stage and intervention stage were 3.40% and 0.95% respectively;incidence of SSI before and after inter-vention was significantly different(χ2= 12.02,P<0.01). Univariate analysis on evaluation stage showed that risk factors for SSI in patients with caesarean section were duration of operation≥1 hour,body mass index≥26 kg/m2,intraoperative blood loss ≥300 mL,underlying diseases,premature rupture of membranes,and without antimicro-bial prophylaxis(all P<0.05). In evaluation stage,648 patients received post-operative antimicrobial prophylaxis for>48 hours(n= 395,60.96%);in intervention stage,945 patients received post-operative antimicrobial prophy-laxis for<24 hours(n= 776,82.12%),different time distribution of post-operative antimicrobial prophylaxis in two stages after intervention was compared,difference was statistically significant(χ2= 673.26,P<0.01). The mean length of hospital stay of 31 SSI patients were(13.83±3.26)days,non-SSI patients were(7.06±1.66) days,difference was statistically significant(t= 7.86,P<0.01);the average hospitalization expenses for patients with SSI were(9 044.77±2 649.19)yuan,non-SSI patients were(6 254.73±638.52)yuan,difference was statis-tically significant(t= 4.344,P<0.01).Conclusion Intervention measures for risk factors of SSI after caesarean section can effectively reduce the incidence of SSI in caesarean section.
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Objective To understand the occurrence of healthcare-associated infection(HAI) in intensive care units (ICUs) in secondary and above hospitals in a province, and provide basis for HAI management.Methods HAI management quality control center in a province performed targeted monitoring on HAI in ICUs in secondary and above hospitals in a province from July 1, 2010 to June 30, 2015.Results ICUs in 176 hospitals were monitored, the incidence of HAI in ICUs for 6 consecutive years was 7.23％, case incidence of HAI was 9.72％;incidence of HAI showed a decreased trend in 6 years(P0.05).A total of 36 223 strains of pathogens were isolated, the top 6 isolated pathogens were Acinetobacter baumannii(22.77％), Klebsiella pneumoniae (11.96％), Pseudomonas aeruginosa(11.94％), Staphylococcus aureus (8.08％), Candida albicans (5.63％), and Escherichia coli(5.55％).The isolation rates of carbapenem-resistant Klebsiella pneumoniae showed a increased tendency for 6 years(P<0.05).Conclusion Continuous targeted monitoring on HAI in ICUs, regular analysis on risk factors for HAI, and timely implementation of intervention measures can effectively decrease the incidence of HAI.
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Objective To monitor ventilator-associated event (VAE) for the first time in an intensive care unit (ICU) in China,understand the applicability,incidence,and clinical significance of VAE in China.Methods Targeted monitoring on VAE was performed among patients ≥18 years and with mechanical ventilation (MV)＞2 days in the ICU of a hospital between January 2014 and September 2015,incidence of VAE was calculated,and patients were grouped according to whether or not they had VAE,prognostic factors were analyzed statistically.Results A total of 1 004 patients were monitored,the total hospital stay was 13 795 days in patients who used ventilator,307 (30.58％) cases of VAE occurred,incidence of VAE per 1 000 ventilator-days was 22.25.Univariate analysis showed that patients with VAE had longer length of ICU stay and MV,and higher mortality rate than patients without VAE when they moved out of ICU (all P＜0.05).Multivariate logistic regression analysis showed that VAE was independent risk factor for length of ICU stay,duration of MV,as well as mortality when patients moved out of ICU(all P＜0.05).Conclusion Judgment of VAE is based on MV parameters,it is more objective and accurate.There is a high incidence of VAE among ICU patients,it may lead to poor clinical outcomes,and has good values for the targeted monitoring on ICU patients in large comprehensive hospitals of China.
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Objective To assess the impact factors of surgical site infection(SSI) in the department of general surgery,the improve the quality of the target of monitoring,provide clinical theoretical basis for reducing the incidence of SSI.Methods In 2015,920 patients who underwent general surgery was took in the targeted monitoring of SSI.SPSS19.0 software was used to analyzing the data.Results The infection rate was 4.35％;Surgical site infection rate was rising,with the increase of NNIS.17 pathogens were isolated,including 11 Escherichia colis which was the most.The incidence of the SSI was 2.40％ between two groups in the patients who underwent the elective surgeries 10.85％,in the patients who underwent emergency surgery.there was significant difference between two groups(x2 =27.997,P＜0.05).The type Ⅱ surgical incision was smain type in the department of general surgery,the incidence of the typeⅡ surgical incision was 2.27％,the incidence of the typeⅢ surgical incision was 21.90％,no SSI occurred in the type Ⅰ surgical incision;SSI incidence of surgery time which was more than 3 h was 7.27％,less than 3 h was 3.71 ％,there was significant difference between two groups(x2 =4.136,P＜0.05);the SSI incidence of the incision length ≥10 cm was 13.11 ％,less than 10 cm was 1.82％,the difference was statistically significant (x2=48.966,P＜0.05).Conclusion NNIS score,wound type,type of surgery,duration of surgery may become the risk factors SSI.
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Objective To evaluate the effect of targeted monitoring and comprehensive intervention measures on reducing the occurrence of catheter-associated urinary tract infection(CAUTI)in patients in non-intensive care unit(Non-ICU).Methods In quarter 4 of 2015,patients with indwelling urinary catheter in clinical departments were conducted a baseline survey(before intervention),risk factors for CAUTI in patients were analyzed,targeted monitoring programmes and comprehensive intervention measures were initiated in 2016(after intervention),incidence of CAUTI before and after intervention was compared.Results After taking intervention measures,hand hygiene compliance rate increased from 78.51%in quarter 4 of 2015 to 92.99%in quarter 3 of 2016 and 90.73%in quarter 4 of 2016(x2=7.342,3.998,respectively,both P<0.05),the correct disposal rate of patients' urinary catheterization system increased from 72.83%in quarter 4 of 2015 to 95.44%in quarter 4 of 2016(x2=30.267,P<0.05).A total of 12 067 patients with indwelling urinary catheter were monitored,incidence of CAUTI dropped from 1.03%(24/23 313)in quarter 4 of 2015(before intervention)to 0.53%(14/26 595)in quarter 4 of 2016(after intervention),difference was statistically significant(x2=4.126,P=0.042).Conclusion Improving the quality of urinary catheterization system in patients with indwelling catheter through targeted monitoring can effectively reduce the incidence of CAUTI in patients in Non-ICU.
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Objective To understand the status of infection with multidrug-resistant organisms (MDROs) in intensive care units(ICUs),and evaluate the intervention efficacy of targeted monitoring.Methods Prospective study was adopted,patients who were admitted to ICUs in 2014-2015 were selected (January-December 2014 was as preintervention stage,January-December 2015 was as intervention stage),trend of MDRO infection before and after intervention were compared and analyzed.Results Before and after intervention,297 and 217 strains of MDROs were isolated respectively,except carbapenem-resistant Pseudomonasaeruginosa (CRPA),the isolated strains of carbapenem-resistant Acinetobacterbaunannii (CRAB),carbapenem-resistant Enterobacteriaceae (CRE),methicillin-resistant Staphylococcus aureus(MRSA),and vancomycin-resistant Enterococcus (VRE) declined after intervention.MDRO infection rate declined from 7.17 ％ before intervention to 3.88％ after intervention,infection rate of CRAB and CRE after intervention were both lower than before intervention (both P＜0.05);MDRO infection rates in general ICU and internal medicine ICU increased from 8.75％ and 7.84‰ before intervention to 4.39‰ and 2.28％ after intervention,respectively (both P＜0.05).After taking comprehensive intervention measures,compliance to prevention and control measures,such as ordering rate of doctor's advice on contact isolation for 24 hours,hand hygiene,health care workers' awareness all enhanced significantly(all P＜0.05).Conclusion Targeted monitoring and intervention measures can reduce isolation rate of MDROs in ICUs.
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Objective To summarize the effectiveness in monitoring activities for healthcare-associated infection (HAI)in China in the past 30 years,explore the changing trend in HAI monitoring,find a new model for the moni-toring of HAI in China.Methods A total of 194 comprehensive hospitals and military hospitals in 13 provinces (au-tonomous regions,municipalities)were selected,questionnaire survey was adopted to investigate the situation of HAI monitoring.Results Of 194 hospitals,184 (94.85%)had available data after being checked,incidence of HAI in secondary and tertiary hospitals were 0.78% and 1.58% respectively,difference was significant (P <0.01).Monitoring was divided into two stages,cumulative percentage of each monitoring activity before 2006 and during 2006-2016 were respectively as follows:environmental hygiene were 73.91% and 100.00%,disinfection ef-ficacy 69.57% and 97.28%,overall comprehensive monitoring 64.67% and 98.91%,surgical site infection(SSI) 13.04% and 94.57%,ICU HAI 4.89% and 87.50%,neonatal HAI 1.75% and 60.82%,multidrug-resistant or-ganisms(MDROs)5.43% and 95.65%,hand hygiene compliance 2.17% and 93.48%,antimicrobial agents 15.22% and 87.50%.The reporting rate of HAI outbreak in tertiary hospitals was higher than secondary hospitals (33.33% [n=37]vs 16.44%[n=12],P =0.01).Conclusion The monitoring of HAI in China starts late,but develops rapidly,defects still exist in HAI monitoring system,reporting rate of HAI cases is still high,reporting rate of HAI outbreak is low.
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Objective To investigate the current situation of healthcare-associated infection(HAI)management in secondary and above medical institutions in Shaanxi Province,analyze development trend,and put forward sugges-tions for improvement.Methods In May-June,2016,170 secondary and above hospitals in 10 cities were selected for surveying through stratified random sampling method.Survey content included basic situation of hospitals,HAI management,HAI monitoring,and so on.Results Available questionnaires were obtained from 165 hospitals (43 tertiary hospitals,and 122 secondary hospitals).Of 165 hospitals,more than 90% have established HAI manage-ment organizations and regulations,but hospital risk management should be paid more attention,only 63.03% of hospitals perfected the risk management system and 66.06% conducted risk assessment.99.09% of hospitals im-plement training on HAI to all staff regularly and 88.41% conducted effective feedback.In the aspect of staff alloca-tion,88.48% of the hospitals assigned enough professionals for HAI management,but only 34.55% have specific training programme for these personnel.Only 33.94% of hospitals have special funds for HAI control;in the aspect of monitoring on HAI,21.21% of hospital installed and used HAI monitoring software;In the aspect of implemen-tation of monitoring programme,about 90% of hospitals developed monitoring on HAI cases and environmental hy-giene,but only 34.55% and 23.64% of hospitals conducted targeted monitoring on intensive care unit and neonatal intensive care unit respectively.Conclusion Organizational structure of HAI management in Shaanxi Province is perfect,relevant rules and regulations are basically established,basic monitoring projects are universal,but the awareness of risk management needs to be strengthened,professional allocation and professional quality develop-ment are both imbalance,informational monitoring is inadequate.
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Objective To understand the status and pathogenic characteristics of healthcare-associated infection (HAI)in cardiovascular surgical intensive care unit (ICU)patients undergoing heart transplantation.Methods Pa-tients who underwent heart transplantation in a hospital between July 1 ,2013 and June 30,2014 were performed targeted monitoring.Results Of 66 patients undergoing heart transplantation,16 developed 18 times of HAI,inci-dence of HAI was 24.24%.Incidence of HAI and ventilator-associated pneumonia(VAP)in patients undergoing heart transplantation were both higher than non-transplantation patients (24.24% vs 6.24%,χ2 =33.718;7.58%vs 1 .72%,χ2 =12.199,respectively,both P <0.001 ).The infection tyes were as follows:lower respiratory tract infection(n=7),VAP (n=6),bacteremia (n=3),superficial incision infection (n =1 ),as well as skin and soft tissue infection (n = 1 ). The isolated pathogens were fungus (n = 8 ),Klebsiella pneumoniae (n = 3 ), Staphylococcus aureus (n=2),Acinetobacter baumannii (n=2),Enterobacter cloacae (n=1 ),Acinetobacter hae-molyticus (n=1 ),and Citrobacter freundii (n =1 ).Conclusion Incidence of HAI is high in patients undergoing heart transplantation,the main infection type is lower respiratory tract infection,the major pathogen is fungus.
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Objective To investigate the effect of targeted monitoring on the control of central venous catheter associated infection, study the difference of CVC?RI infection rate and the distribution of pathogenic bacteria in the general hospital and the maternal and child hospital, and analyse the main pathogenic bacteria drug resistance characteristics. Methods From January 2013 to December 2014,685 cases patients with central venous catheterization in the Port Hospital of Hebei Port Group Company Limited,and four cooperative hospitals ( Affiliated Hospital of North China University of Science and Technology, People′s Hospital of Tangshan, Tangshan Port Economic Development District Hospital, Maternal and Child Health Care Hospital of Laoting County) were selected as the research objects. The difference of infection rate before and after the targeted monitoring in 2014 was compared. The tip of the catheter and the peripheral blood were cultured in the patients with suspected infection,bacterial identification and drug sensitivity test were carried out using Compact VITEK2 automatic bacteria identification/drug sensitivity analyzer. Results The infection rate of CVC?RI of five hospitals was 18. 75%( 60/320 ) in 2013, 11. 51%( 42/365 ) in 2014, the difference of infection rate was statistically significant before and after the implementation of the target monitoring(χ2=7. 059,P0. 05). In 102 cases of CVC?RI,105 bacterial strains were detected in 91 cases,gram positive bacteria accounted for 51. 43%( 54/105) ,gram negative bacilli accounted for 40. 95%( 43/105) ,fungi accounted for 7. 62%( 8/105) . There was no significant difference in the proportion of pathogenic bacteria in the general hospital and the maternal and child hospital(P>0. 05). Grampositive cocci were mainly staphylococcus aureus and coagulase negative staphylococci,they were completelysensitive to linezolid, quinupristin/ dalfopristin, tigecycline, and vancomycin. They were high sensitivity torifampicin,while highly resistant to gentamicin, tetracycline, penicillin; Gram negative bacilli were mainlypseudomonas aeruginosa and escherichia coli,they were high sensitivity to meropenem,imipenem,while resistantto multiple antimicrobia1s. Conclusion Adhere to the implementation of targeted monitoring help to reduce theoccurrence of CVC?RI. The isolation of pathogenic bacteria from multiple drug resistance should be paid moreattention.
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Objective To understand the results and characteristics of targeted monitoring of healthcare-associated infection (HAI)in an intensive care unit (ICU)of a tumor hospital,so as to provide scientific basis for formulating measures of prevention and control of HAI.Methods Patients who admitted to an ICU from January to December 2013 were performed targeted monitoring,incidence of HAI was adjusted with an average severity of illness score (ASIS),three types of invasive procedure-related infection,distribution of pathogens,and multidrug-resistant or-ganisms were monitored.Results A total of 455 patients were monitored,the total patient-days were 2 483 days, 52 cases of HAI occurred,incidence of HAI was 11 .43%,incidence of HAI per 1 000 patient-days was 20.94‰,af-ter the adjustment with ASIS,incidence of HAI per 1 000 patient-days was 6.29‰.The main infection site was re-spiratory system(63.46%),followed by urinary system(19.23%);Incidence of ventilator-associated pneumonia per 1 000 ventilation-days,catheter-related bloodstream infection per 1 000 catheter-days,and catheter-associated urinary tract infection per 1 000 urinary catheter days were 12.08‰,0.95‰,and 4.07‰ respectively.A total of 181 path-ogenic isolates were detected,74.59% (n=135)of which were gram-negative bacteria,18.23%(n=33)were gram-positive bacteria,and 7.18%(n=13)were fungi;18.23%(n=33)were multidrug-resistant strains.Conclusion ICU is the high risk department of the occurrence of HAI,the main infection is respiratory tract infection,the major pathogen is gram-negative bacteria.Targeted monitoring can timely reflect the deficiency in infection control practice,is helpful for formula-ting effective prevention and intervention measures,and reducing the occurrence of HAI.
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Objective To investigate the incidence of surgical site infection(SSI)and compliance to bundle inter-vention measures on SSI following total abdominal hysterectomy in patients in department of gynaecology of a tertia-ry first-lass hospital,and evaluate the efficacy of bundle intervention measures in prevention and control of SSI. Methods From March 2014 to October 2015,all gynecology patients undergoing total abdominal hysterectomy were as targeted monitored subjects,March-September 2014 was baseline investigation stage,October 2014 to Oc-tober 2015 was intervention stage(new bundle intervention measures were performed),compliance to bundle inter-vention measures and incidence of SSI before and after intervention were compared.Results A total of 222 episodes of total abdominal hysterectomy were monitored,the incidence of SSI was 5 .86% ,the operation P75 time were 2 hours. Compared with the baseline stage,the compliance to most traditional intervention measures improved after intervention,the largest increase in the compliance to interventions was follow-up after surgery (increased by 64.16% ),followed by preoperative perineal disinfection(increased by 39.07% )and hand hygiene(increased by 21 .34% ). Compliance to new intervention measures was 100.00% . Incidence of SSI following total abdominal hys-terectomy after intervention was significantly lower than before intervention(2.27% [3/132]vs 11.11% [10/90]), difference was significant (χ2= 7.583,P<0.05).Conclusion Targeted monitoring on SSI following total abdomi-nal hysterectomy can improve compliance to bundle intervention measures and decrease incidence of SSI.
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Objective To monitor the incidence of catheter-associated infection (CAI)in patients in general inten-sive care unit (ICU),and provide basis for taking proper prevention and control measures.Methods Targeted monitoring method was conducted,incidence of healthcare-associated infection (HAI)among patients receiving urinary catheterization,intravascular catheterization,and tracheal intubation in the general ICU of a tertiary hospital between January 2012 and December 2013 were surveyed.Results A total of 299 ICU patients with catheterization were investigated,the overall hospitalization days were 2 700 days,41 patients developed 48 episodes of HAI, incidence of HAI was 13.71%,case incidence was 16.05%,incidence of HAI per 1 000 catheter days was 15.19‰,37 patients developed 44 episodes of CAI;the other types of HAI were blood stream infection(n=1),skin and soft tissue infection(n = 1 ),antibiotic-associated diarrhea(n = 1 ),and herpes zoster(n = 1 ).Incidence of catheter-associated urinary tract infection (CAUTI),catheter-related bloodstream infection (CRBSI),and ventilator-associated pneumonia (VAP ) per 1 000 catheter days were 2.94‰,2.12‰,and 15.72‰ respectively. Conclusion CAI is the main HAI type in ICU patients with catheterization,and the major is VAP.
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Objective To evaluate the effect of bundle intervention measures on preventing ventilator-associated pneumonia (VAP).Methods Patients who were admitted to an intensive care unit(ICU)of a hospital from January 2012 to December 2013 were monitored,patients from January to December 2012 were as control group,while from January to December 2013 were as intervention group (bundle intervention measures were implemented).Usage rate of ventilators and incidence of VAP between two groups were compared.Results A total of 4 560 patients were mo-nitored,2 608 in intervention group and 1 952 in control group.Usage rate of ventilators in intervention group was lower than control group (53.95% vs 61 .17%;χ2 =65.756,P <0.01).Incidence of VAP per 1 000 ventilator days in intervention group was lower than control group (13.00‰ vs 19.56‰;χ2 =4.649,P =0.031 ).Percentage of late-onset VAP per 1 000 ventilator days in tervention group was higher than control group(41 .82‰ vs 24.59‰). Conclusion Bundle intervention measures are helpful for reducing the incidence of VAP in ICU patients.
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Objective To investigate the incidence and risk factors for surgical site infection (SSI)in clean wound orthopedics surgery.Methods SSI among patients receiving clean wound orthopedic surgery from April 1 to Sep-tember 30 in 2014 were monitored,risk factors for SSI were analyzed.Results A total of 665 patients were moni-tored,14 cases(2.11 %)of SSI occurred.Univariate analysis showed that types of skin,skin preparation modes, and ASA score were risk factors for SSI in clean wound orthopedic surgery (all P <0.05 ).Multivariate logistic analysis revealed that conventional skin preparation,ASA score ≥ grade Ⅱ,and duration of operation ≥90 minutes were independent risk factors for SSI in patients receiving clean wound orthopedic surgery (OR [95%CI ],3.96 [1 .07-14.70],6.45[1 .97-21 .11],and 4.08[1 .35 -12.30]respectively).Conclusion The improved method of skin preparation,grade I ASA score,and shortening duration of operation can reduce the incidence of SSI in clean wound orthopedic surgery,on the basis of improving the autoimmunization of patients,strengthening prevention and control of healthcare-associated infection can reduce the incidence of SSI in clean wound orthopedic surgery.
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OBJECTIVE:to provide reference for the continuous improvement of surgical site infection (SSI). METHODS:There were totally 7 472 patients with typeⅠand typeⅡincision surgeries in a hospital after the targeted monitoring and special recti-fication(Jul. 2012 to Jun. 2013,monitoring group)and 5 958 patients with surgeries during the same period before special rectifi-cation(Jul. 2010 to Jun. 2011,control group). The clinic data of typeⅠand typeⅡincision surgical was compared,including infec-tion,the perioperative antibiotics use and hospitalization time after surgery,etc. RESULTS:The infection rate of typeⅠand typeⅡstandardized incision in monitoring group was respectively 0.35% and 0.43% and control group was respectively 0.60% and 1.36%(P<0.05). The rate of typeⅠincision perioperative antibiotics use in monitoring group was 10.72% and control group was 86.88%(P<0.05). The post-operative non-medication rate of patients was increased from the 6.98%(control group)to 49.20%(monitor-ing group)(P<0.05),the discontinuance rate within 48 h was increased from the 32.09%(control group)to 44.11%(monitoring group),and the ratio of patients who took antibiotics after the surgery for more than 3 d was decreased from the 42.82%(control group)to 3.05%(monitoring group)(P<0.05). The inguinal hernia repair time in monitoring group was 3.90 d,shorter than con-trol group(4.22 d)(P=0.018). The patient with gallbladder surgery in monitoring group was 6.47 d,compared with control group (6.38 d),there was no significant difference (P=0.619). CONCLUSIONS:The special rectification can obviously promote the standardized of perioperative antibiotics use,reduce the incidence of SSI and shorten the hospitalization time after operation.
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Objective To explore the incidence of surgical site infection (SSI)and compliance to bundled interven-tion measures,and evaluate the effect of bundled interventions on controlling SSI.Methods From October 2013 to September 2014,three types of surgeries (colorectal surgery,abdominal hysterectomy,and femoral neck repair sur-gery)in 29 hospitals in China were monitored,October 2013 to March 2014 was baseline investigated stage,April 2014 to September 2014 was intervention stage.Results A total of 6 166 episodes of surgeries were monitored,the incidence of SSI was 1 .64%,incidence of SSI following colorectal surgery,abdominal hysterectomy,and femoral neck repair surgery were 4.47%,1 .03%,and 0.21 % respectively.The P 75 time of three types of surgeries were 3,2,and 2 hours respectively.Compared with the baseline stage,the compliance to most intervention measures im-proved after intervention,the largest increase in the compliance to interventions was disinfection with chlorhexidine-containing disinfectant at surgical sites of colorectal surgery (increased by 29.09%),followed by preoperative shower of femoral neck repair surgery (increased by 26.24%),preoperative shower of colorectal surgery(increased by 22.95%),and skin preparation on the day of operation (increased by 20.75%).Incidences of SSI in three types of surgeries were not significantly different before and after intervention(all P >0.05).Conclusion The incidences of SSI are different among different types of surgeries,the compliance to most bundled intervention measures has im-proved to some extent after intervention,but effectiveness of intervention measures needs to be further observed.
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Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.