Present Situation and Risk Factors for Surgical Patients Associated with Postoperative Nosocomial Infection in A Second-grade Class-A Hospital of Chengdu_West China Medical Journal

Authors：

 ZHANGJu ¹ ,  SUWei ² , LIGang ³

1. Department of Nosocomial Infection Management, the First People's Hospital of Longquanyi District of Chengdu, Chengdu, Sichuan 610100, P. R. China;
2. Faculty of Health Management, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Anorectal Department, the First People's Hospital of Longquanyi District of Chengdu, Chengdu, Sichuan 610100, P. R. China;

Corresponding?author：

SUWei, Email: suweiab@163.com

Keywords：

Nosocomial infection; Perioperative period; Antibacterial drug use; Pathogens; Risk factors

DOI：

10.7507/1002-0179.20140132

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the risk factors for surgical patients associated with postoperative nosocomial infection through monitoring the infection conditions of the patients, in order to provide a scientific basis for the development of hospital infection control measures in a second-grade class-A hospital in Chengdu City. Methods We conducted the survey with cluster sampling as the sampling method and the uniform questionnaire in the departments of orthopedic, neural and thoracic surgery from July 2011 to June 2012. The main parameters we observed were the patients'general and surgical conditions, antibiotics usage and hospital infection situation. Data were analyzed using the National Nosocomial Infection Surveillance Network software and chi-square test of single factors. Results In this survey, we monitored 50 cases of postoperative hospital infection. The infection rate was 7.73% and the highest infection rate was in the Neurosurgery Department. The main site of infection was lower respiratory tract, followed by surgical site. The different usage time of antimicrobial drug in perioperative period resulted in different infection rates, and the difference was statistically significant (χ²=601.50, P<0.005). The rate of adjusted postoperative hospital infection was higher than pre-adjusted rate except that of the neurosurgery doctor 4. The risk factors associated with hospital postoperative infection in our hospital were:patients'conditions including underlying disease, emergency surgery, type of anesthesia, operative duration, hospital stay and postoperative drainage. Most of the hospital infection cases were caused by bacteria of the gram-negative bacilli, and the major pathogens were Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii in our hospital. Conclusion The hospital should particularly strengthen the prevention and control of hospital infection in patients after neurosurgical operations. For patients with basic diseases, we should actively improve the patients'physical conditions before operation and control the primary lesion. Targeted control measures should be taken for different factors related to surgery. Reasonable selection of antimicrobial agents should be based on the epidemic strains in our hospital.

Citation： ZHANGJu, SUWei, LIGang. Present Situation and Risk Factors for Surgical Patients Associated with Postoperative Nosocomial Infection in A Second-grade Class-A Hospital of Chengdu. West China Medical Journal, 2014, 29(3): 440-444. doi: 10.7507/1002-0179.20140132 Copy

1.	高冰. 手術室對手術部位感染的預防和控制[J]. 中外醫療, 2011(12):189-190.
2.	王麗娜, 馮紅燕, 馬貴芳. 手術患者醫院感染的危險因素[J]. 中華醫院感染學雜志, 2012, 22(8):1598-1599.
3.	Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee[J]. Am J Ifect Control, 1999, 27(2):97-132.
4.	Smith BA. Anesthesia as a risk for health care acquired infections[J]. Perioperat Nurs Clin, 2010, 5(4):427-441.
5.	蘆杰, 胡海霞. 神經外科醫院感染調查分析[J]. 中國實驗診斷學, 2011, 15(8):1337-1339.
6.	徐華, 李衛光, 王一兵, 等. 胸外科食管癌與肺癌手術部位感染目標性監測[J]. 中華醫院感染學雜志, 2012, 22(21):4761-4763.
7.	雷國榮, 譚黎杰. 80例胸外科術后患者醫院感染原因分析與預防[J]. 中華醫院感染學雜志, 2012, 22(11):2315-2316.
8.	Suka M, Yoshida K, Takezawa J. Epidemiological approach to nosocomial infection surveillance data:the Japanese Nosocomial Infection Surveillance System[J]. Environ Health Prev Med, 2008, 13(1):30-35.
9.	徐綠萍, 陳衛平. 骨科手術切口感染相關因素分析及護理對策[J]. 中華醫院感染學雜志, 2013, 23(3):554-556.
10.	李世敏. 手術室醫院感染管理的現狀分析與對策[J]. 齊齊哈爾醫學院學報, 2009, 30(3):355-356.
11.	周靜蕓. 麻醉后發生下呼吸道感染的臨床分析[J]. 基層醫學論壇, 2009, 13(19):590-592.
12.	Venkatesan AM, Kundu S, Sacks D, et al. Practice guideline for adult antibiotic prophylaxis during vascular and interventional radiology procedures[J]. J Vasc Interv Radiol, 2010, 21(11):1611-1630.
13.	郭新軍, 王鵬, 朱振軍. 開放性骨折患者感染的高危因素調查研究[J]. 中華醫院感染學雜志, 2012, 22(10):2090-2092.
14.	鄔飛娟. 手術部位感染的危險因素調查分析及護理對策[J]. 中國實用護理雜志, 2012, 28(3):57-58.
15.	韓玲樣, 孟葆莉, 張會萍. 外科手術部位感染目標性監測結果分析[J]. 中華醫院感染學雜志, 2012, 22(21):4750-4752.
16.	石新華, 劉建軍, 王秀華, 等. 外科圍術期預防性抗生素應用調查分析[J]. 齊魯護理雜志, 2010, 16(8):122-123.
17.	孟軍, 周健, 江淑芳, 等. 1360例次消化道手術部位感染目標性監測分析[J]. 中國感染控制雜志, 2011, 10(6):416-419.
18.	趙萬春. 外科手術切口感染病原菌的分布及耐藥性[J]. 中華醫院感染學雜志, 2013, 23(3):692-694.
19.	朱建和, 蘭雷鈞, 王啟斌, 等. 多發性肋骨骨折并發下呼吸道感染的原因分析及對策[J]. 中華醫院感染學雜志, 2013, 23(3):557-559.

1. 高冰. 手術室對手術部位感染的預防和控制[J]. 中外醫療, 2011(12):189-190.
2. 王麗娜, 馮紅燕, 馬貴芳. 手術患者醫院感染的危險因素[J]. 中華醫院感染學雜志, 2012, 22(8):1598-1599.
3. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee[J]. Am J Ifect Control, 1999, 27(2):97-132.
4. Smith BA. Anesthesia as a risk for health care acquired infections[J]. Perioperat Nurs Clin, 2010, 5(4):427-441.
5. 蘆杰, 胡海霞. 神經外科醫院感染調查分析[J]. 中國實驗診斷學, 2011, 15(8):1337-1339.
6. 徐華, 李衛光, 王一兵, 等. 胸外科食管癌與肺癌手術部位感染目標性監測[J]. 中華醫院感染學雜志, 2012, 22(21):4761-4763.
7. 雷國榮, 譚黎杰. 80例胸外科術后患者醫院感染原因分析與預防[J]. 中華醫院感染學雜志, 2012, 22(11):2315-2316.
8. Suka M, Yoshida K, Takezawa J. Epidemiological approach to nosocomial infection surveillance data:the Japanese Nosocomial Infection Surveillance System[J]. Environ Health Prev Med, 2008, 13(1):30-35.
9. 徐綠萍, 陳衛平. 骨科手術切口感染相關因素分析及護理對策[J]. 中華醫院感染學雜志, 2013, 23(3):554-556.
10. 李世敏. 手術室醫院感染管理的現狀分析與對策[J]. 齊齊哈爾醫學院學報, 2009, 30(3):355-356.
11. 周靜蕓. 麻醉后發生下呼吸道感染的臨床分析[J]. 基層醫學論壇, 2009, 13(19):590-592.
12. Venkatesan AM, Kundu S, Sacks D, et al. Practice guideline for adult antibiotic prophylaxis during vascular and interventional radiology procedures[J]. J Vasc Interv Radiol, 2010, 21(11):1611-1630.
13. 郭新軍, 王鵬, 朱振軍. 開放性骨折患者感染的高危因素調查研究[J]. 中華醫院感染學雜志, 2012, 22(10):2090-2092.
14. 鄔飛娟. 手術部位感染的危險因素調查分析及護理對策[J]. 中國實用護理雜志, 2012, 28(3):57-58.
15. 韓玲樣, 孟葆莉, 張會萍. 外科手術部位感染目標性監測結果分析[J]. 中華醫院感染學雜志, 2012, 22(21):4750-4752.
16. 石新華, 劉建軍, 王秀華, 等. 外科圍術期預防性抗生素應用調查分析[J]. 齊魯護理雜志, 2010, 16(8):122-123.
17. 孟軍, 周健, 江淑芳, 等. 1360例次消化道手術部位感染目標性監測分析[J]. 中國感染控制雜志, 2011, 10(6):416-419.
18. 趙萬春. 外科手術切口感染病原菌的分布及耐藥性[J]. 中華醫院感染學雜志, 2013, 23(3):692-694.
19. 朱建和, 蘭雷鈞, 王啟斌, 等. 多發性肋骨骨折并發下呼吸道感染的原因分析及對策[J]. 中華醫院感染學雜志, 2013, 23(3):557-559.

Previous Article
Prevalence Rate of Nosocomial Infection from 2011 to 2013
Next Article
Antibiotics Use in Perioperative Period of Hernioplasty by Intervention-control Study

West China Medical Journal

Present Situation and Risk Factors for Surgical Patients Associated with Postoperative Nosocomial Infection in A Second-grade Class-A Hospital of Chengdu

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content