Consecutive 6year targeted monitoring on healthcareassociated infection in intensive care units in 176 hospitals

Abstract:

ObjectiveTo 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. MethodsHAI 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. ResultsICUs 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（P＜0.001）. The adjusted rate of HAI per 1 000 patient days in the general hospital ICUs was higher than that of special hospital ICUs (4.30‰ vs 3.53‰）. Incidence of HAI in surgical ICUs and general ICUs were both relatively higher, adjusted rates of HAI per 1 000 patient days were 4.79‰ and 4.21‰ respectively. Respiratory tract, urinary tract, and bloodstream infection were major HAI in ICUs, accounting for 68.64%, 14.45%, and 10.09% respectively, the utilization rates of central venous catheter, ventilator, and urinary catheter were 49.86%, 39.16%, and 81.95% respectively, incidence of three catheterassociated infection were 1.74‰, 13.77‰, and 2.08‰ respectively, incidence of three catheterassociated infection decreased year by year (P<0.001). The utilization rates of ventilator, central venous catheter, and urinary catheter in different ICUs were not correlated with the incidence of infection(all P>0.05). 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). ConclusionContinuous 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.