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

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

Birth Weight ; Catheterization, Central Venous ; adverse effects ; Cross Infection ; etiology ; prevention & control ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Mycoses ; prevention & control ; Risk Factors

OBJECTIVETo investigate the risk factors and the pathogens of nosocomial infection in preterm infants.

METHODSThe medical data of 197 preterm infants with nosocomial infection were retrospectively studied.

RESULTSThe incidence of nosocomial infection was 22.2% (197/887). Small gestational age (OR=4.125, p<0.05), low birth weight (OR=5.450, p<0.05), mechanical ventilation therapy (OR=4.435, p<0.05) and delayed enteral feedings (OR=3.765, p<0.05) were found to be important risk factors for nosocomial infection. Klebsiella was the main pathogen (22.3%), followed by Staphylococcus (18.4%).

CONCLUSIONSHygienic handwashing, decreasing invassive procedures and an early start of enteral feeding are crucial for preventing nosocomal infection in preterm infants. Klebsiella is the main pathogen of nosocomal infections.

Cross Infection ; epidemiology ; etiology ; prevention & control ; Enteral Nutrition ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Male ; Respiration, Artificial ; Retrospective Studies ; Risk Factors

OBJECTIVETo explore risk factors of injection-related sharp injury and to provide safety injection guidance to healthcare takers.

METHODSA cross-sectional survey and 1:1 case-control study was used to study the epidemiological features and risk factors of sharp injuries among 3010 clinical nurses and nurse students from 13 hospitals in Guangzhou. Logistic multiple factor analysis was used.

RESULTSEighty-seven point five percent of nurses have suffered injuries at last once time. During the past month, 37.6% of the nurses have suffered injuries at least once time. The frequency of the injuries was 0.84 per person month. Through multiple logistic regression analysis, data showed that the risk factors leading to the sharp injuries in orders were: contacting the needle more frequently, subjectively thinking that the sharp injuries as unavoidable, the atmosphere in the nursing unit was not harmonious enough, recapping habit, carelessness at work, too many patients that not cooperating, breaking the ampule off without using carbasus, crowded and noisy working place, lack of acknowledge on prevention, lack of the awareness on how to avoiding the accident, having an initiative and creative personality etc.

CONCLUSIONThe results provided a foundation for the department of infection control in the hospital and sanitary administration department to constitute safety injection policies.

Case-Control Studies ; China ; epidemiology ; Cross Infection ; epidemiology ; etiology ; prevention & control ; Cross-Sectional Studies ; Female ; Hand Injuries ; epidemiology ; etiology ; Humans ; Injections ; Logistic Models ; Male ; Needles ; Needlestick Injuries ; epidemiology ; Nursing Staff, Hospital ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires

PURPOSE: Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors. MATERIALS AND METHODS: The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI. RESULTS: Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number> or =12 (p=0.024), body mass index (BMI)>25 kg/m2 (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI>25 kg/m2 (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI. CONCLUSIONS: Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.
Aged ; Anti-Bacterial Agents/*therapeutic use ; Antibiotic Prophylaxis/methods ; Cross Infection/etiology/prevention & control ; *Drug Resistance, Bacterial ; Fluoroquinolones/*therapeutic use ; Humans ; Image-Guided Biopsy/*adverse effects/methods ; Incidence ; Male ; Middle Aged ; Prostatic Neoplasms/*pathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Ultrasonography, Interventional ; Urinary Tract Infections/epidemiology/*etiology/prevention & control

OBJECTIVETo investigate the preventive effect and clinical significance of garlicin injection on ventilator-associated low respiratory tract deep-seated fungal infection (VRFI) as pneumonia.

METHODSRetrospectively analysis on 147 patients underwent mechanical ventilation in our Intensive Care Unit (ICU) in recently 3 years was conducted. According to the garlicin injection administration was used or not, 79 patients with WVUH (West Virgina University Hospital) score > or = 25 points were selected and divided into the preventive group and the control group, and the differences in baseline conditions, incidence of VRFI and hospital outcome between the two groups were compared.

RESULTSThere was no significant difference between the two groups in baseline data as age, sex, APACHE II score, SAPS II score and WVUH score. But the incidence of VRFI in the preventive group was significantly lower than that in the control group (P<0.01). The relative risk in the latter was 2.06 (95% CI, 1.25-3.38). No significant difference was found between the two groups in hospital mortality (P>0.05).

CONCLUSIONGarlicin injection can effectively reduce the incidence of VRFI, and is inexpensive, it is an ideal prophylactic anti-fungal drug.

Adult ; Aged ; Aged, 80 and over ; Allyl Compounds ; therapeutic use ; Antifungal Agents ; therapeutic use ; Cross Infection ; etiology ; prevention & control ; Disulfides ; therapeutic use ; Female ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Mycoses ; prevention & control ; Pneumonia ; microbiology ; prevention & control ; Respiration, Artificial ; adverse effects ; Retrospective Studies ; Risk Factors

OBJECTIVETo explore the feasibility of replacement of ordinary syringes by auto-disposal syringes (AD) in China.

METHODSSampling survey was conducted in Hebei province to collect data on the direct medical spending of hepatitis B and their Disability Adjusted Life Year (DALY) losses. The financial burden on hepatitis B was calculated based on the result of field survey as well as through data-base of the Second National Health Services Survey of MOH in 1998. The cost-benefit analysis was employed, in which the saving of the financial burden on hepatitis B patients attributing to unsafe injections was taken as the benefit of intervention and the increased expenditures of AD syringes as the costs.

RESULTSThe total financial disease burden of Hepatitis B in China in 2001 was between RMB 16.19 and 20.17 billion Yuan and the financial disease burden per patient was between RMB 1755.38 and 1409.64 Yuan. Study on the cost-benefit analysis in the replacement intervention program showed high financial feasibility. The Benefit-Cost Ratio (BCR) of the measure was between 32.46 and 97.39, which was bigger in rural areas than that in cities. The direct BCR was less than one when the price gap between ordinary syringe and AD exceeded RMB 0.24 Yuan.

CONCLUSIONThe intervention of safe injection practice through universal usage of AD to replace ordinary syringe seemed to be applicable due to its high potential economic benefits.

China ; epidemiology ; Cost-Benefit Analysis ; Cross Infection ; economics ; etiology ; prevention & control ; Cross-Sectional Studies ; Disposable Equipment ; economics ; statistics & numerical data ; Equipment Reuse ; statistics & numerical data ; Female ; Hepatitis B ; economics ; transmission ; Humans ; Injections ; adverse effects ; economics ; instrumentation ; Male ; Risk Factors ; Sampling Studies ; Surveys and Questionnaires ; Syringes ; economics

PURPOSE: To assess the rates of infectious complications before and after the change of prophylactic antibiotic regimens in prostate needle biopsy. MATERIALS AND METHODS: The records of 5,577 patients who underwent prostate needle biopsy at Asan Medical Center between August 2005 and July 2012 were retrospectively reviewed. Group 1 (n=1,743) included patients treated between 2005 and 2009 with fluoroquinolone for 3 days, group 2 (n=2,723) included those treated between 2009 and 2012 with ceftriaxone once before the biopsy and fluoroquinolone before biopsy and continue therapy for 3 days, and group 3 (n=1,111) received the same treatment for more than 7 days after the biopsy. Univariable and multivariable logistic regression models addressed risk factors associated with infectious complication after prostate needle biopsy. RESULTS: Infectious complication after prostate needle biopsy developed in 18 (group 1), seven (group 2), and two patients (group 3) (p=0.001). In group 1, seven patients with infectious complication had positive blood cultures and harbored fluoroquinolone-resistant Escherichia coli, four had ceftriaxone susceptible isolates, and three had extended spectrum beta-lactamase-positive E. coli. Two patients in group 1 required intensive care because of septic shock. In multivariable analysis, the patients with combination of fluoroquinolone and ceftriaxone had significantly lower infectious complication rate than the fluoroquinolon alone (p=0.003). CONCLUSIONS: Antibiotic prophylaxis with ceftriaxone and fluoroquinolone before prostate needle biopsy decreased the risk of potentially serious infectious complications.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibiotic Prophylaxis/*methods ; Biopsy, Needle/adverse effects/methods ; Ceftriaxone/*therapeutic use ; Cross Infection/epidemiology/etiology/*prevention & control ; Drug Evaluation/methods ; Drug Resistance, Bacterial ; Drug Therapy, Combination ; Escherichia coli/drug effects ; Escherichia coli Infections/epidemiology/prevention & control ; Fluoroquinolones/*therapeutic use ; Humans ; Incidence ; Male ; Middle Aged ; Prostatic Neoplasms/*pathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Ultrasonography, Interventional ; Young Adult