Clinical characteristics and prognostic factors of elderly patients with CA-BSI in a hospital from 2017 to 2021 / 中国感染控制杂志

Objective To explore the clinical characteristics and prognostic factors of elderly patients with commu-nity-acquired bloodstream infection(CA-BSI),and provide basis for clinical treatment and prevention.Methods Medical records of elderly patients diagnosed with CA-BSI in a tertiary first-class hospital of Changsha from 2017 to 2021 were collected.Patients were divided into a survival group and a death group according to the prognosis after 30 days hospitalization.The differences in clinical data between two groups of patients were compared,and influen-cing factors for the prognosis in CA-BSI patients were analyzed.Results A total of 575 elderly CA-BSI patients were included in the analysis,with 535 cases in the survival group and 40 cases in the death group.Univariate ana-lysis results suggested that death of elderly CA-BSI patients was related to gender,age,history of hemodialysis,glucocorticoid usage,indwelling catheter,concomitant heart disease,albumin,creatinine,and sequential organ fai-lure assessment(SOFA)score(all P＜0.05).Multivariate logistic regression analysis results suggested that old age(OR=1.062,95％CI:1.016-1.109),high SOFA score(OR=1.161,95％CI:1.067-1.262),glucocorti-coid usage(OR=6.006,95％CI:2.441-14.774)were independent risk factors for the death of elderly CA-BSI patients,while normal albumin(OR=0.942,95％CI:0.891-0.995)was a protective factor.Conclusion Elderly CA-BSI patients have high risks of death.It is necessary to improve the immunity of patients as well as use antimi-crobial agents and glucocorticoids rationally,so as to reduce the risk of death in patients.

Effect of performance appraisal through third party survey on improving the compliance of hand hygiene among health care workers / 中国感染控制杂志

Objective To understand the actual implementation of hand hygiene(HH)of health care workers(HCWs), and provide evidence for improving HH management.Methods HH performance appraisal began to implement in a hospital in 2016, at the same time, third party(healthcare-associated infection management professionals in other hospitals)was invited to carry out 4 times of anonymous survey on HH among HCWs in the hospital, change in HH compliance rate among HCWs was compared.Results HH compliance of HCWs surveyed by the third party was 60.68％, HH rates in the first half and second half year were 52.72％and 68.62％respectively, difference was statistically significant(P＜0.001).Compliance rate of HH in key departments(intensive care unit and neonatal department, 87.44％)was higher than surgical departments(64.71％)and internal medicine departments(53.74％), difference was statistically significant(both P＜0.05).HH compliance rates of HCWs before and after contact with patients and after contact with the surrounding environment of patients were all low(53.59％, 58.07％, 43.97％, respectively).Conclusion HH surveyed by the third party can effectively reduce the Hawthorne effect during the observation process.HH performance appraisal can significantly improve the compliance of HH among HCWs.