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Hand hygiene compliance among health care workers in a hospital

Yingying HU ; Xiaocheng CHEN ; Zongming LIU ; Yurong GAO ; Weiqi WANG

Chinese Journal of Infection Control.2015;(5):339-341. doi:10.3969/j.issn.1671-9638.2015.05.014

Objective To investigate hand hygiene status of health care workers (HCWs)in a hospital,and pro-vide guides for improving hand hygiene compliance.Methods Hand hygiene intervention was adopted in a hospital between 2012 and 2014,hand hygiene compliance among HCWs and healthcare-associated infection in patients be-tween August 1 and August 31 of each year were investigated and analyzed statistically.Results In 2102 -2014, hand hygiene compliance rate of HCWs was 59.55%,62.13%,and 65.16% respectively,which showed a increased trend (χ2 =10.018,P =0.002),HAI rate was 2.13%,1 .48% and 1 .06% respectively,which showed a decreased trend (χ2 =82.377,P <0.001 );hand hygiene compliance rate of doctors was lower than nurses (57.97% vs 65.97%);Of different hand hygiene moments,hand hygiene compliance rate was the lowest before touching a pa-tient(41 .32%),and highest after body fluid exposure (76.47%).Conclusion Comprehensive hand hygiene inter-vention in this hospital has achieved preliminary results,improvement of HCWs’hand compliance is helpful for pre-venting HAI.

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Distribution and antimicrobial resistance of clinically isolated pathogens in hematology department from 2011 to 2013

Fangfei LIU ; Yun YANG ; Yan GENG ; Yi ZHANG

Chinese Journal of Infection Control.2015;(5):306-310. doi:10.3969/j.issn.1671-9638.2015.05.005

Objective To analyze the distribution and antimicrobial resistance of pathogens isolated from department of hematology during the past three years.Methods Pathogenic strains isolated from patients hospitalized in a hematology de-partment between January 2011 and December 2013 were collected,antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion method or automatic system,antimicrobial susceptibility testing results were judged according to American Clinical and Laboratory Standards Institute 2011, data were analyzed by WHONET 5.6 software. Results A total of 462 clinical isolates were collected in 2011—2013,including 161 gram-positive cocci isolates,279 gram-negative bacilli,and 22 fungi.Of Staphylococcus spp ,detection rate of methicillin-resistant coagulase negative Staphylo-coccus(MRCNS)and methicillin-resistant Staphylococcus aureus (MRSA)was 81.37% and 62.50%respectively.The re-sistant rate of Staphylococcus spp .and Enterococcus spp .to linezolid was 1.69% and 3.57% respectively,resistant rate of Staphylococcus spp .to teicoplanin was 3.39%,vancomycin-resistant gram-positive coccus was not found.Enterobacte-riaceae strains Escherichia coli and Klebsiella pneumoniae were highly susceptible to carbapenems,the sensitivity rates were 97.56%—98.88%;while nonfermentative gram-negative bacilli Pseudomonas aeruginosa and Acinetobacter bauman-nii strains were obviously resistant to carbapenems,the resistance rates were 38.71%—64.00%.Conclusion Antimicrobial resistance of major pathogenic strains from hematology department is high,antimicrobial agents should be used according to pathogenic distribution characteristics and antimicrobial susceptibility testing results,healthcare-associated infection control should be strengthened to reduce antimicrobial resistant rate.

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Incidence and prevention measures of catheter-related bloodstream infec-tion in intensive care units

Yanli HU ; Xiaoqin WU ; Lin LI

Chinese Journal of Infection Control.2015;(5):302-305. doi:10.3969/j.issn.1671-9638.2015.05.004

Objective To investigate the management of prevention and control of catheter-related bloodstream in-fection (CRBSI)in intensive care units (ICUs)of tertiary hospitals in a city,and explore stategies.Methods Data about CRBSI prevention and control as well as quality management were collected and surveyed by self-developed questionnaires.Results Of ICUs in 8 hospitals,the incidence of CRBSI was 4.81 ‰,case infection rate was 5.02‰.6 (75.00%)hospitals had standard operating instruction for the prevention and control of CRBSI, 2 (25.00%)hospitals had maintenance record on central venous catheter,and 2(25.00%)hospitals implemented maximum sterile barrier and catheterization combination strategy,none hospital adopted anti-infective dressing and chlorhexidine bathing.Conclusion There are many problems in the standard operating instruction and implementa-tion of measures for the prevention and control of CRBSI in ICUs of tertiary hospitals in this city,which needs to be improved.

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Change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients

Xiangyi YIN ; Xiaoli XU ; Niuyan NIE ; Hongmei FANG ; Huimin HUANG ; Xiaoyue SHEN

Chinese Journal of Infection Control.2015;(5):298-301. doi:10.3969/j.issn.1671-9638.2015.05.003

Objective To explore the change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients,and provide reference for clinical prevention and treatment.Methods Specimens from 9 extensive burn patients who were admitted to a hospital at the same time were performed pathogenic culture and an-timicrobial susceptibility testing, change trend and antimicrobial susceptibility of pathogens were observed. Results The main specimen was wound secretion,accounting for 93.81 %.The major pathogens causing infection were Acinetobacter baumannii (44.85%),Staphylococcus aureus (32.47%),Pseudomonas aeruginosa (12.37%), and Klebsiella pneumoniae (5.15%).With the prolongation of hospital stay,pathogens changed from one kind to multiple strains, and from susceptibility to resistance,multidrug resistance,and extensive drug resistance. Conclusion Itis difficult to avoid infection in burn patients,timely realizing the changes of pathogens causing infec-tion and antimicrobial resistance play an important role in the control of infection.

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Retrospective analysis on pathological diagnosis of primary pulmonary cryptococcosis in 32 immunocompetent persons

Jinyun PENG ; Jianhong XIAO ; Fangduo HAN

Chinese Journal of Infection Control.2015;(5):294-297. doi:10.3969/j.issn.1671-9638.2015.05.002

Objective To understand clinical characteristics of primary pulmonary cryptococcosis (PPC),so as to provide reference for clinical diagnosis and treatment.Methods Clinical data of 32 patients who were confirmed PPC by pathological diagnosis in a hospital from January 2008 to June 2014 were analyzed retrospectively. Results All 32 cases were community-acquired infection ,26 male and 6 female (age between 17 and 62 years old, the average age was (35.53 ± 11 .29).Among 32 patients,8 had underlying diseases,2 were parturients,4 were carpenters,5 were pigeon keepers,3 were seafood transport drivers,and 10 lived in humid environment.Imaging findings:Solitary or multiple nodules and cluster shape(n=21),lobar consolidation(n=2),diffuse patchy shadow on bilateral lung (n=5),pulmonary cavity(n=3),and diffuse and mixed lesions (n=1).Pathological confirmation:di-agnosis through percutaneous lung biopsy(n=23),thoracoscopic surgery(n=7),and thoracotomy(n=2).Progno-sis:30 were cured,and 2 had marked effect.Conclusion PPC is commonly occurs in young and middle-aged immu-nocompetent persons,the onset is occult,clinical manifestations and imaging features lack specificity,can be easily misdiagnosed or omitted diagnosis,diagnosis is difficult,lack rapid diagnostic method in clinical practice,invasive pathological biopsy can be used as the basis of diagnosis;there is a controversy on therapy,adverse reaction of flu-conazol is mild,and has good therapeutic effect.

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Influence of different training methods in hand hygiene compliance of health care workers

Qin MIAO ; Minghua ZHU ; Zemei BAI ; Hua LIU ; Purong ZHANG ; Haitao LIU ; Jingtang HE ; Li SUN

Chinese Journal of Infection Control.2015;(6):416-418. doi:10.3969/j.issn.1671-9638.2015.06.015

Objective To train health care workers (HCWs)by method of conventional training plus survey of hand contamination status,the influence of two kinds of methods in hand hygiene compliance of HCWs was evalua-ted.Methods From November 2013 to April 2014,all HCWs in a cardiovascular internal medicine department were as trained subjects,they were divided into two groups (trial group and control group).Hand hygiene compli-ance status was investigated 1 month before training.In the first month after training,conventional training method was adopted by both groups,from the second to fifth month,conventional training plus hand contamination survey was adopted by trial group,hand hygiene compliance between two groups were compared.Results Hand hygiene compliance rates of trial group and control group was 42.63% (107/251 )and 41 .80% (102/244)respectively be-fore training,there was no significant difference(P >0.05 ).In the first and second month after training,hand hygiene compliance rate of trial group was 55.70% (132/237)and 63.11 % (154/244)respectively,control group was 56.52% (130/230)and 62.61 % (149/238)respectively,compared with pre-training,the differences were sig-nificant (both P <0.05),but the difference was not significant between two groups(P >0.05);From the third to fifth month,hand hygiene compliance rates of trial group was 60.73%(150/247),61 .44%(145/236),and 61 .22%(150/245)respectively,control group was 51 .68%(123/238),51 .02%(125/245 ),and 52.32% (124/237)respec-tively,there was significant difference between two groups(P <0.05).Conclusion Conventional training combined with survey of hand contamination status can promote hand hygiene compliance of HCWs.

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Constructing a questionnaire for patients to participate in hand hygiene promotion in medical institutions

Lina ZHANG ; Jufang FU ; Wei LIU ; Yong GUO ; Yali YIN ; Yaping WU ; Jing ZHANG ; Huali ZHANG ; Hong QU

Chinese Journal of Infection Control.2015;(6):393-398. doi:10.3969/j.issn.1671-9638.2015.06.009

Objective To construct a questionnaire for patients to participate in hand hygiene promotion in medical institutions,and provide a measuring tool for patients to participate in hand hygiene promotion.Methods A ques-tionnaire was constructed by methods of literature research,expert panel discussion,pre-investigation,and Delphi. Results This questionnaire was designed respectively for patients and health care workers,each contained 20 ques-tions,involving hand hygiene perception,willingness to participate in promoting hand hygiene,and participation method,et al.Conclusion A questionnaire for patients to participate hand hygiene promotion in medical institutions is preliminary constructed,which can be used for evaluating patients’and HCWs’willingness and relevant influen-cing factors of patients’participation in hand hygiene promotion in medical institutions.

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Effect of antimicrobial-impregnated incise drape on preventing surgical site infection following neurosurgical operation

Ling HU ; Changyi LU ; Cuifeng YANG ; Jia LIU ; Jinyou GUO

Chinese Journal of Infection Control.2015;(6):389-392. doi:10.3969/j.issn.1671-9638.2015.06.008

Objective To investigate the effect of antimicrobial-impregnated incise drape on preventing surgical site in-fection(SSI)following neurosurgical operation.Methods Patients undergoing neurosurgical operation from January to De-cember 2012 were divided into two groups:antimicrobial-impregnated incise drape group(group A)and general incise drape group(group B).The occurrence of SSI and risk factors for SSI were analyzed.Results Percentage of drape lifting at the wound edge in group A was lower than group B(38.3%[98/256]vs 96.88% [248/256],χ2 =200.57,P <0.01).Among 512 patients,SSI rate was 3.32%(n=17),SSI rate in group A was lower than group B(1.56%[4/256]vs 5.08%[13/256],χ2 = 7.93,P <0.05 ).Multivariate analysis revealed that body mass index ≥24,perioperative hypothermia,smok-ing,perioperative length of hospital stay ≥5 days,and lack of drape use were independent risk factors for SSI following neurosurgical operation.Conclusion Whether antimicrobial-impregnated incise drape is used in neurosurgical operation is one of the independent risk factors for SSI following neurosurgical operation,it can effectively reduce the drape lifting rate and incidence of SSI,and is recommended to be used in neurosurgical operation.

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Drug resistance and department distribution of Mycobacterium tuberculosis in a county-level hospital

Chunming SHEN ; Qiaozhen WU ; Wenying WU ; Xiaoyan NI ; Hao SHEN

Chinese Journal of Infection Control.2015;(6):386-388. doi:10.3969/j.issn.1671-9638.2015.06.007

Objective To explore drug resistance and distribution of multidrug-resistant(MDR)Mycobacterium tuberculosis (M.tuberculosis)in a county-level hospital,so as to strengthen the prevention and control of health-care-associated infection with M.tuberculosis .Methods Specimens with positive sputum smear were performed M. tuberculosis culture and drug resistance testing,and distribution of MDR tuberculosis patients in the departments before isolation were investigated retrospectively.Results Of 488 patients with tuberculosis,254 were positive for sputum smear,122 M.tuberculosis strains were isolated from positive sputum smear patients,120 isolates were per-formed drug susceptibility testing,results revealed that 86 isolates were drug-resistant strains,46 of which were monodrug-resistant,40 were MDR.Of MDR strains,16 were all resistant to isoniazide,rifampicin,streptomycin, and ethambutol.The percentage of monodrug-resistance,MDR,pandrug resistance was 9.43%,8.20%,and 3.28% respectively.Medical imaging department,ultrasound department,and respiratory disease department were the main units of M.tuberculosis exposure.Conclusion The percentage of MDR M.tuberculosis is high among M. tuberculosis ,surveillance should be intensified,so as to prevent the transmission in hospital.

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Risk factors and treatment of hospital-acquired pneumonia due to multi-drug-resistant organisms in intensive care unit

Jingjing HAN ; Yaqing XU ; Yuhong HE ; Chenliang ZHOU ; Qing YE ; Hong YU ; Hongxia ZHOU ; Yujia CHENG

Chinese Journal of Infection Control.2015;(6):374-378. doi:10.3969/j.issn.1671-9638.2015.06.004

Objective To analyze risk factors and antimicrobial use for hospital-acquired pneumonia (HAP)due to multidrug-resistant organisms (MDROs)in an intensive care unit(ICU),so as to perform risk assessment and guide antimicrobial use.Methods From January 2012 to December 2013,HAP patients were conducted retrospective co-hort study,risk factors for MDRO-HAP and rationality of antimicrobial use were analyzed.Results A total of 110 cases of HAP occurred in ICU,63 cases (57.27%)were MDR-HAP.Logistic regression analysis revealed that re-cent hospital stay ≥5 days (OR=19.94),transference from other hospitals (OR =19.33),infection type of late-onset HAP (OR=7.98),and antimicrobial use in recent 90 days (OR =3.42)were independent risk factors for MDR-HAP.Initial empirical anti-infective treatment revealed that there were no significant difference in timing of antimicrobial administration within 24 hours after clinical diagnosis was confirmed,and rationality of antimicrobial selection between MDR-HAP group and non-MDR-HAP group (both P >0.05);The isolation rate of pathogens in MDR-HAP group was lower than non-MDR-HAP group (73.02% vs 91 .49% P <0.05 ).Targeted antimicrobial therapy revealed that there were no significant difference in selection,dosage,and frequency of antimicrobial use be-tween two groups(all P >0.05 );the rationality rate of therapy course in MDR-HAP group was higher than no-MDR-HAP group,but rationality rate of combination use of antimicrobial agents was slightly lower than the latter (both P < 0.05 ).Conclusion Patients in ICU should be conducted risk factor assessment,and according prevention and control measures should be formulated,so as to reduce the occurrence of MDR-HAP,health care workers should standardized the initial empirical anti-infective treatment.

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