Welcome to visit Zhongnan Medical Journal Press Series journal website!

Home Articles Vol 27,2024 No.5 Detail

Analysis of epidemiological characteristics of nosocomial infection in the neurosurgery deparment of a class A tertiary general hospital from 2019 to 2022

Published on May. 31, 2024Total Views: 169 times Total Downloads: 198 times Download Mobile

Author: YANG Chuanwei 1 LI Na 1 SUN Min 2 ZHANG Xinyue 1 WANG Hao 3

Affiliation: 1. Department of Pharmacy, Jinan Fourth People's Hospital, Jinan 250031, China 2. Department of Clinical Pharmacy, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250014, China 3. Department of Intensive Care, Qilu Hospital of Shandong University, Jinan 250012, China

Keywords: Neurosurgery Nosocomial infection Carbapenem resistant Acinetobacter baumannii Epidemiology Resistance Antimicrobial agent

DOI: 10.12173/j.issn.1008-049X.202401051

Reference: YANG Chuanwei, LI Na, SUN Min, ZHANG Xinyue, WANG Hao.Analysis of epidemiological characteristics of nosocomial infection in the neurosurgery deparment of a class A tertiary general hospital from 2019 to 2022[J].Zhongguo Yaoshi Zazhi,2024, 24(5):772-778.DOI: 10.12173/j.issn.1008-049X.202401051.[Article in Chinese]

  • Abstract
  • Full-text
  • References
Abstract

Objective  To investigate and analyze the epidemiological characteristics of nosocomial infection in the neurosurgery department of Jinan Fourth People's Hospital, and to provide reference for nosocomial infection prevention and control and rational use of antibiotics.

Methods  The infection related information of 5 200 inpatients in neurosurgery from January 2019 to December 2022 was retrospectively collected through the hospital infection monitoring system and hospital information system, and the distribution of infection sites, the incidence of hospital infection, distribution of pathogens and drug resistance were statistically and descriptively analyzed.

Results  From 2019 to 2022, the average infection rate of inpatients in the neurosurgery department was 3.3%, which was decreased year by year (χ2=39.000, P<0.001). Nococomial infections mostly occurred in elderly male patients, the infection sites were mainly lower respiratory tract, urinary system, bacteremia, and intracranial infection. From 2019 to 2022, 296 strains of pathogenic bacterium were detected in neurosurgery, including 207 strains of Gram-negative bacteria, accounting for 69.9%; 53 Gram-positive bacterium, accounting for 17.9%; 36 Fungi, accounting for 12.2%. The top four pathogens were Klebsiella pneumoniae (21.6%), Pseudomonas aeruginosa (12.5%), Escherichia coli (9.8%), and Acinetobacter baumannii (8.8%). The drug sensitivity results showed that the resistance of Acinetobacter baumannii to carbapenems was significant.

Conclusion  In the past four years, the incidence of nosocomial infections of the Neurosurgery department has improved year by year. The pathogenic bacteria detected were mainly gram-negative bacteria, and the problem of drug resistance is more prominent. The drug resistance management should be strengthened.

Full-text
Please download the PDF version to read the full text: download
References

1. Glynn E, Fitzpatrick F, Dinesh B, et al. Integrated infection surveillance in neurosurgery to inform patient management[J]. J Infect, 2023, 87(1): 91-92. DOI: 10.1016/j.jinf.2023.05.002.

2. Rafa E, Kołpa M, Wałaszek MZ, et al. Healthcare-acquired infection surveillance in neurosurgery patients, incidence and microbiology, five years of experience in two Polish units[J]. Int J Environ Res Public Health, 2022, 19(12): 7544. DOI: 10.3390/ijerph19127544.

3. Bi X, Zheng L, Yang Z, et al. Retrospective study of the epidemiology of Clostridioides difficile infection in the neurosurgery department of a tertiary hospital in China[J]. Infect Drug Resist, 2023, 16: 545-554. DOI: 10.2147/IDR.S397544.

4. 霍军丽, 王毓, 邓琪, 等. 神经外科患者术后下呼吸道感染病原学及肺炎克雷伯菌耐药基因检测[J]. 中华医院感染学杂志, 2023, 33(7): 1066-1070. [Huo JL, Wang Y, Deng Q, et al. Etiological characteristics of postoperative lower respiratory tract infections in patients of neurosurgery department and drug resistance genes in Klebsiella pneumonia[J]. Chinese Journal of Nococomiology, 2023, 33(7): 1066-1070.] DOI: 10.11816/cn.ni.2023-221021.

5. Pan SJ, Hou Y, Yang YP, et al. Relationship between nosocomial infections and coronavirus disease 2019 in the neurosurgery unit: clinical characteristics and outcomes from a Chinese tertiary-care hospital[J]. BMC Infect Dis, 2022, 22(1): 836. DOI: 10.1186/s12879-022-07845-x.

6. 徐思露, 吴楠, 蔡宁, 等. 《国家三级公立医院绩效考核操作手册(2022版)》药事管理指标解读及思考[J]. 中国药房, 2022, 33(13): 1541-1547. [Xu SL, Wu N, Cai N, et al. Interpretation and thinking of indicators of pharmaceutical administration in National Tertiary Public Hospitals Performance Evaluation Operational Manual (2022 edition)[J]. China Pharmacy, 2022, 33(13): 1541-1547.] DOI: 10.6039/j.issn.1001 -0408.2022.13.02.

7. 中华人民共和国国家卫生健康委员会. 关于印发医院感染诊断标准(试行)的通知[EB/OL]. (2001-11-07)[2024-01-03]. http://www.nhc.gov.cn/wjw/gfxwj/201304/37cad8d95582456d8907ad04a5f3bd4c.shtml.

8. Humphries R, Bobenchik AM, Hindler JA, et al. Overview of changes to the clinical and laboratory standards istitute Performance Standards for Antimicrobial Susceptibility Testing, M100, 31st edition[J]. J Clin Microbiol, 2021, 59(12): e0021321. DOI: 10.1128/JCM.00213-21.

9. Liu G, Qin M. Analysis of the distribution and antibiotic resistance of pathogens causing infections in hospitals from 2017 to 2019[J]. Evid Based Complement Alternat Med, 2022, 2022: 3512582. DOI: 10.1155/2022/3512582.

10. 殷丽军, 武娜娜, 缪瑾, 等. 2017—2021年某儿科医院耐碳青霉烯类革兰阴性菌综合干预感控措施效果及其耐药基因[J]. 中华医院感染学杂志, 2024, 34(3): 410-415. [Yin LJ, Wu NN, Miao J, et al. Evaluation of effectiveness of comprehensive intervention infection prevention and control measures on carbapenem-resistant Gram-negative bacilli of drug resistance genes in pediatric hospital in 2017-2021[J]. Chinese Journal of Nosocomiology, 2024, 34(3): 410-415.] DOI: 10.11816/cn.ni.2024-238484.

11. 黄泽玉, 郑光辉, 吕红, 等. 神经外科术后患者手术部位感染肺炎克雷伯菌和鲍曼不动杆菌分子流行病学研究[J]. 国际检验医学杂志, 2020, 41(15): 1818-1812, 1825. [Huang ZY, Zheng GH, Lyu H, et al. Epidemilogical study on surgical site infection of Klebsiella pneumonia and Acinetobacter baumannii in post-neurosurgical patients[J]. International Journal of Laboratory Medicine, 2020, 41(15): 1818-1812, 1825.] DOI: 10.3969/j.issn. 1673-4130.2020.10.006.

12. 方旭, 金立德, 赵建华. 841例神经外科手术患者医院感染特征及危险因素分析[J]. 中华医院感染学杂志, 2012, 22(19): 4240-4242. [Fang X, Jin LD, Zhao JH. Characteristics and risk factors for nosocomial infections in 841 patinets in department of neurosurgery[J]. Chinese Journal of Nosocomiology, 2012, 22(19): 4240-4242.] DOI: CNKI:11-3456/R.20121017.1712.025.

13. Paules CI, Marston HD, Fauci AS. Coronavirus infections more than just the common cold[J]. JAMA, 2020, 323: 707-708. DOI: 10.1001/jama.2020.0757.

14. 蔡虻, 刘聚源. 城市或地区聚集性疫情中医院感染风险及防控措施的探讨[J]. 华西医学, 2022, 37(3): 326-329. [Cai H, Liu JY. Infection risk and prevention and control measures of nosocomial infection in urban or regional clustered epidemic[J]. West China Medical Journal, 2022, 37(3): 326-329.] DOI: 10.7507/1002- 0179.202202070.

15. Tan Y, Wang J, Zhao K, et al. Preliminary recommendations for surgical practice of neurosurgery department in the central epidemic area of 2019 coronavirus infection[J]. Curr Med Sci, 2020, 40(2): 281-284. DOI: 10.1007/s11596-020-2173-5.

16. Hu F, Guo Y, Yang Y, et al. Resistance reported from China antimicrobial surveillance network (CHINET) in 2018[J]. Eur J Clin Microbiol Infect Dis, 2019, 38(12): 2275-2281. DOI: 10.1007/s10096-019-03673-1.

17. 全国细菌耐药监测网. 全国细菌耐药监测网2014—2019年不同等级医院细菌耐药监测报告[J]. 中国感染控制杂志, 2021, 20(2): 95-111. DOI: 10.12138 /j.issn.1671-9638.20216180.

18. Kyriakidis I, Vasileiou E, Pana ZD, et al. Acinetobacter baumannii antibiotic resistance mechanisms[J]. Pathogens, 2021, 10(3): 373. DOI: 10.3390/pathogens10030373.

19. 郭咸希, 何文, 陈莹, 等. 我院95例鲍曼不动杆菌感染患者抗感染治疗回顾性分析[J]. 中国药师, 2022, 25(5): 836-841. [Guo XX, He W, Chen Y, et al. Retrospective analysis of anti-infective therapy for 95 patients with Acinetobacter baumannii infection in our hospital[J]. China Pharmacist, 2022, 25(5): 836-841.] DOI: 10.19962/j.cnki.issn1008-049X.2022.05.015.

20. Darby EM, Trampari E, Siasat P, et al. Molecular mechanisms of antibiotic resistance revisited[J]. Nat Rev Microbiol, 2023, 21(5): 280-295. DOI: 10.1038/s41579-022-00820-y.

21. Blair JMA, Webber MA, Baylay AJ, et al. Molecular mechanisms of antibiotic resistance[J]. Nat Rev Microbiol, 2015, 13: 42-51. DOI: 10.1038/nrmicro3380.

22. 王海涛, 张抗怀, 谢姣, 等. 临床药师对重症监护室抗菌药物相关药物相互作用的研究及药学服务[J]. 中国药师, 2023, 26(10): 125-131. [Wang HT, Zhang KH, Xie J, et al. Research and pharmaceutical services by clinical pharmacists on antibiotic-related drug interaction in ICU[J]. China Pharmacist, 2023, 26(10): 125-131.] DOI: 10.12173/j.issn.1008-049X. 202205707.

Popular papers
Last 6 months