Cross Infection ; epidemiology ; etiology ; prevention & control ; Humans

OBJECTIVETo assess the risk factors for nosocomial blood-stream infection (BSI) in a neonatal intensive care unit (NICU).

METHODSClinical data from the neonates admitted to the NICU in the St. Louis Children's Hospital in Washington University School of Medicine between January 2005 and December 2006 were retrospectively studied.

RESULTSA total of 1 290 neonates were included. Overall, 175 nosocomial BSIs occurred. Catheter-related BSIs accounted for 62.3% (109 cases). The incidence of nosocomial BSI was 4.22 per 1 000 patient-days. Logistic regression analysis revealed that low gestational age, low Apgar scores at 5 minutes, use of central venous catheter (CVC), and longer CVC use were risk factors for the development of nosocomial BSI. In the subgroup of neonates with CVC, mechanical ventilation was an additional independent risk factor for BSI.

CONCLUSIONSCatheter-related BSI is the major source of nosocomial BSI in the NICU. Prematurity, low Apgar scores at birth and prolonged CVC use are risk factors for the development of BSI.

Bacteremia ; etiology ; Cross Infection ; etiology ; Female ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Logistic Models ; Male ; Risk Factors

BACKGROUNDCurrently, slightly more than 50% of bloodstream infections (BSIs) are hospital acquired. When these infections occur in patients in intensive care units, they are associated with a high mortality rate, additional hospital days and excess hospital costs. Because of multifactor of nosocomial BSIs, measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice. The aim of this study was to explore special way in accordance with self-hospital base on common principle.

METHODSIn one ward of the Intensive Care Unit, Peking Union Medical College Hospital, at first, we divided the all operation about bloodstream way into three sections used as keypoints. By surveying keypoints respectively, some operation faults of blood way were discovered. For decreasing the mobidity of nosocomial BSIs, some intervention measurements were executed. The rate of nosocomial BSIs was analyzed by chi-square test.

RESULTSAccording to the statistics from January to June, we received and cured 618 patients in total; among them, there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month. After intervention measurements from July to December 2011, we received and cured 639 patients in total with seven cases of nosocomial BSI, and the average occurrence was 1.2 cases/month (P < 0.05). From January to April 2012, no nosocomial BSI occurred in the investigated ward.

CONCLUSIONRemoving the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.

Adult ; Aged ; Bacteremia ; etiology ; prevention & control ; therapy ; Cross Infection ; etiology ; prevention & control ; therapy ; Female ; Humans ; Male ; Middle Aged

Burn Units ; Cross Infection ; therapy ; Drug Resistance ; Humans ; Pneumonia ; etiology ; therapy ; Respiratory Tract Infections ; etiology ; therapy ; Ventilators, Mechanical ; adverse effects

OBJECTIVEIn May 2013, an abnormal increase of surgical-site infection among post cesarean section patients was reported at one hospital in Zhongshan. An investigation was conducted to identify the risk factors and related control measures.

METHODSAll the reported surgical-site infection records among post cesarean section patients were checked. A review of cesarean section schedules of health workers was also performed. An 1 : 2 case-control study was conducted among surgical-site infection cases in May 2013. Microbiologic cultures were performed on 2 surgical site secretion samples and 12 samples from the environment. All the positive isolates were molecular typed by pulsed field gel electrophoresis (PFGE).

RESULTSIn May 2013, 4 post cesarean section patients who developed surgical-site infection symptom at one hospital in Zhongshan were reported, with an attack rate as 10.3% (4/39). The emergence time of symptom was 2-3 days after operation. All of the 4 cases underwent an emergency operation. The median time interval for cases from admission to operation was 7.2 hours (ranged from 2 to 9 hours), lower than that seen in the controls, with a median time of 20.8 hours (Z = 5.50, P = 0.03). Two of the 4 cases took type-B ultrasonic inspection 1.4 h and 8.4 h before the operation, and the other two cases took continuous fetal heart monitoring 2 hours before the operation. Skin of the operation area on the 4 cases had been exposed to ultrasonic couplant, without a thorough clean. The proportion of type-B ultrasonic inspection or continuous fetal heart monitoring was much higher in cases than in controls (χ² = 5.19, P = 0.01). Burkholderia cepacia (BC) isolates were discovered from:one surgical site secretion, 2 type-B ultrasonic probe samples, one ultrasonic couplant in use and one ultrasonic couplant unopened. All the isolates were identified as 100% identical by PFGE.

CONCLUSIONThe skin of operation area of cesarean section patients had been exposed to BC contaminated ultrasonic couplant without thorough cleaning, which seemed to be related to the outbreak of surgical-site infection, in our case.

Adolescent ; Adult ; Burkholderia cepacia ; Case-Control Studies ; Cesarean Section ; Cross Infection ; etiology ; Equipment Contamination ; Female ; Humans ; Pregnancy ; Surgical Wound Infection ; etiology ; Young Adult

Methicillin resistant Staphylococcal aureus (MRSA) enterocolitis is characterized by high fever, abdominal distension, and watery diarrhea that leads to severe dehydration, shock, a sharp decrease in the white cell counts and sometimes multiple organ failure. Clinically, it can be an another cause of nosocomial diarrhea. If MRSA enteritis is suspected from the clinical symptoms, prompt treatment and strict prophylactic measures including vancomycin, are most important for its management. We recently observed a case of MRSA enterocolitis as a nosocomial infection in a patient with acute pancreatitis. This patient showed uncontrolled massive diarrhea, fever, and multiple organ failure. We report a case of MRSA enterocolitis with a review of literatures.
Cross Infection/diagnosis/*microbiology ; Diarrhea/etiology/*microbiology ; Enterocolitis/complications/diagnosis/*microbiology ; Humans ; Male ; *Methicillin Resistance ; Middle Aged ; *Staphylococcal Infections/diagnosis

Aged ; Aged, 80 and over ; Anthracosis ; complications ; microbiology ; Cerebral Infarction ; etiology ; Cross Infection ; complications ; Humans ; Male ; Middle Aged ; Pneumonia ; complications

OBJECTIVEBy measuring airflow and ventilation distribution of ward building, to explore and verify the hypothesis of airborne transmission and risk factor of severe acute respiratory syndrome (SARS) nosocomial infection.

METHODSTracer gas (perfume of plant oil) was emitted to the bathroom of wards when SARS index patient lived. Six different experimental situations were designed to control the status of exhaust fan in bathrooms, exhaust fan in the top of building and fresh air exchange system. The concentration of perfume was separately measured by 4 groups of lab workers and recorded blindly by the scores of "tenth degree".

RESULTSTracer gas was detected from the wards of 8th to 13th floor.

CONCLUSIONArchitecture and ventilation system of the inpatient building in the hospital contributed to the aerodynamic condition of SARS nosocomial infection through airborne transmission. The distribution of tracer gas in the wards was associated with SARS patients in this building. It was possible that SARS could have been transmitted to for distance by aerosol or other carriers.

Air Microbiology ; China ; Cross Infection ; etiology ; Hospitals ; Humans ; SARS Virus ; isolation & purification ; Severe Acute Respiratory Syndrome ; transmission ; Ventilation

OBJECTIVETo study the risk factors of Acinetobacter baummanii in nosocomial infections, and to verify the nature of Acinetobacter baumannii strains isolated from intensive care unit (ICU).

METHODSA hundred and fourty patients associated with nosocomial infection of Acinetobacter baummanii from four teaching hospitals were selected and compared with controls through a case control study to identify risk factors. The strains isolated from the ICU were typed by polymerase chain reaction (PCR) with the primer M(13) following electrophoresis in agarose gel.

RESULTSThe odds ratios (ORs) were: state of the illness (OR = 8.69), using immunosuppressant (OR = 4.85), mechanical ventilation (OR = 3.68) and treatment with 3 kinds of antibiotics (OR = 3.014). Data from PCR studies indicated that these strains were sharing identical band pattern from the five strains.

CONCLUSIONRisk factors for nosocomial infection with Acinetobacter baummanii included state of an illness, immunosuppressant, mechanical ventilation, and treatment with antibiotics. A multidrug-resistant strains of Acinetobacter baumannii was identified in ICU.

Acinetobacter baumannii ; classification ; genetics ; Cross Infection ; etiology ; microbiology ; Genotype ; Humans ; Logistic Models ; Polymerase Chain Reaction ; Risk Factors

Child ; Child, Preschool ; Cross Infection ; epidemiology ; etiology ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Retrospective Studies