Study on the Risk Factors for Intensive Care Unit Nosocomial Infection in a First-class Hospital in Wuxi_West China Medical Journal

Authors：

 ShenBo ¹ , YuRongbin ² , XuQinfen ¹ , NiFangying ¹ , YuYanhua ¹

1. Nosocomial Infection Control Department, Wuxi People's Hospital, Wuxi, Jiangsu 214023, P. R. China;
2. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, P. R. China;

Corresponding?author：

Keywords：

Intensive care unit; Nosocomial infection; Risk factors; Case-control study

DOI：

10.7507/1002-0179.201600427

Video：

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Objective To identify the risk factors of Intensive Care Unit (ICU) nosocomial infection in ICU ward in a first-class hospital in Wuxi, and discuss the effective control measures, in order to provide evidence for making strategies in preventing and controlling nosocomial infection. Methods According to the principle of random sampling and with the use of case-control study, a sample of 100 nosocomial infection patients were selected randomly from January 2012 to December 2014 as survey group, and another 100 patients without nosocomial infection as control group. The data were input using EpiData 2.0, and SPSS 13.0 was used for statistical analysis; t-test and χ² test were conducted, and the risk factors were analyzed using multi-variate logistic regression model. The significant level of P-value was 0.05. Results Based on the results of univariate analysis, there were 13 risk factors for ICU nosocomial infection, including diabetes mellitus, hypoproteinemia, being bedridden, surgical operation, immunosuppression, glucocorticoids, organ transplantation, tracheal intubation, length of hospitalization, length of mechanical ventilation, length of central venous catheter, length of urinary catheter, and length of nasogastric tube indwelling. Multi-variate logistic analysis indicated that hospitalization of 7 days or longer[OR=1.106, 95%CI (1.025, 1.096), P=0.001], diabetes mellitus[OR=2.770, 95%CI (1.068, 7.186), P=0.036], surgical operation[OR=7.524, 95%CI (2.352, 24.063), P=0.001], mechanical ventilation of 7 days or longer[OR=1.222, 95%CI (1.116, 1.339), P<0.001], and nasogastric tube indwelling of 7 days or longer[OR=1.110, 95%CI (1.035, 1.190), P=0.003] were considered as independent risk factors for ICU nosocomial infection. Conclusion Hospitalization of 7 days or longer, diabetes mellitus, surgical operation, tracheal intubation of 7 days or longer, and gastric intubation of 7 days or longer are the major risk factors for nosocomial infection in ICU ward. Advanced intervention and comprehensive prevention measures are helpful to reduce the nosocomial infection rate and ensure the safety of medical treatment.

Citation： ShenBo, YuRongbin, XuQinfen, NiFangying, YuYanhua. Study on the Risk Factors for Intensive Care Unit Nosocomial Infection in a First-class Hospital in Wuxi. West China Medical Journal, 2016, 31(9): 1568-1571. doi: 10.7507/1002-0179.201600427 Copy

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6.	鐘明媚, 王璠, 張琳, 等. 重癥監護病房卒中相關性肺炎的危險因素及病原學分析[J]. 中華急診醫學雜志, 2015, 24(9):1004-1010.
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9.	趙威莉, 李桂云. ICU獲得性感染的危險因素分析及護理干預[J]. 國際護理學雜志, 2013, 32(11):2611-2613.
10.	陳華, 楊雪英, 付秀蓮. 糖尿病并發呼吸道感染的危險因素分析及對策[J]. 中國實用護理雜志, 2008, 24(33):17-18.
11.	張京利, 趙霞, 王力紅, 等. 重癥監護病房患者醫療干預措施與醫院感染的相關性研究[J]. 中華醫院感染學雜志, 2010, 20(2):187-189.
12.	王金鎖, 劉輝, 劉芳芳. 留置導尿病人醫院感染調查[J]. 中國消毒學雜志, 2010, 27(2):206-207.
13.	徐艷, 鄭金鼎, 楊懷, 等. 重癥監護病房多藥耐藥菌目標性監測與干預措施的研討[J]. 中華醫院感染學雜志, 2011, 21(12):2590-2591.
14.	Ji R, Shen H, Pan Y, et al. Novel risk score to predict pneumonia after acute ischemic stroke[J]. Stroke, 2013, 44(5):1303-1309.
15.	Walter U, Knoblich R, Steinhagen V, et al. Predictors of pneumonia in acute stroke patients admitted to a neurological intensive care unit[J]. J Neurol, 2007, 254(10):1323-1329.
16.	陶方萍, 何先弟, 段緩. 綜合ICU內呼吸機相關性肺炎的多因素Logistic回歸分析及護理對策[J]. 中國實用護理雜志, 2010, 26(31):18-20.

1. 謝志宏, 張穎. 重癥監護病房醫院感染及其相關因素分析[J]. 實用預防醫學, 2016, 23(4):459-461.
2. 羅江, 劉運喜, 劉亮, 等. 高齡患者醫院感染直接經濟損失及死亡率研究[J]. 中國熱帶醫學, 2015, 15(6):723-727.
3. 徐麗英, 季俏. ICU中心靜脈導管相關性血流感染干預措施探討[J]. 中華醫院感染學雜志, 2010, 20(12):1695-1697.
4. 中華人民共和國衛生部. 醫院感染診斷標準(試用)[J]. 中華醫學雜志, 2001, 81(5):314-320.
5. 王書會, 周成超, 徐凌忠, 等. 重癥監護病房醫院感染危險因素logistic回歸分析[J]. 中國衛生統計, 2011, 28(5):513-515, 519.
6. 鐘明媚, 王璠, 張琳, 等. 重癥監護病房卒中相關性肺炎的危險因素及病原學分析[J]. 中華急診醫學雜志, 2015, 24(9):1004-1010.
7. 王力紅, 馬文暉, 張京利, 等. APACHEⅡ評分與醫院感染相關性研究[J]. 中華醫院感染學雜志, 2007, 17(6):651-653.
8. 竇英茹, 潘春芳, 單雪芹, 等. 集束預防策略對導管相關性血流感染發生率影響的多因素分析[J]. 中華現代護理雜志, 2012, 18(10):1127-1130.
9. 趙威莉, 李桂云. ICU獲得性感染的危險因素分析及護理干預[J]. 國際護理學雜志, 2013, 32(11):2611-2613.
10. 陳華, 楊雪英, 付秀蓮. 糖尿病并發呼吸道感染的危險因素分析及對策[J]. 中國實用護理雜志, 2008, 24(33):17-18.
11. 張京利, 趙霞, 王力紅, 等. 重癥監護病房患者醫療干預措施與醫院感染的相關性研究[J]. 中華醫院感染學雜志, 2010, 20(2):187-189.
12. 王金鎖, 劉輝, 劉芳芳. 留置導尿病人醫院感染調查[J]. 中國消毒學雜志, 2010, 27(2):206-207.
13. 徐艷, 鄭金鼎, 楊懷, 等. 重癥監護病房多藥耐藥菌目標性監測與干預措施的研討[J]. 中華醫院感染學雜志, 2011, 21(12):2590-2591.
14. Ji R, Shen H, Pan Y, et al. Novel risk score to predict pneumonia after acute ischemic stroke[J]. Stroke, 2013, 44(5):1303-1309.
15. Walter U, Knoblich R, Steinhagen V, et al. Predictors of pneumonia in acute stroke patients admitted to a neurological intensive care unit[J]. J Neurol, 2007, 254(10):1323-1329.
16. 陶方萍, 何先弟, 段緩. 綜合ICU內呼吸機相關性肺炎的多因素Logistic回歸分析及護理對策[J]. 中國實用護理雜志, 2010, 26(31):18-20.

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West China Medical Journal

Study on the Risk Factors for Intensive Care Unit Nosocomial Infection in a First-class Hospital in Wuxi

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