Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015

• Published in: BMC infectious diseases Vol. 19; no. 1; p. 145
• Main Authors: Wang, Linchuan, Zhou, Kai-Ha, Chen, Wei, Yu, Yan, Feng, Si-Fang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.02.2019; BioMed Central; BMC
• Subjects: Analysis; Care and treatment; Cross infection; Epidemiology; Health risks; Hospitals; Immunosuppressive agents; Immunotherapy; Infection; Infectious diseases; Intensive care; Klebsiella; Medical instruments; Medical research; Mortality; Multivariate analysis; Nosocomial infection; Nosocomial infections; Pathogenic microorganisms; Pathogens; Pneumonia; Prevalence studies (Epidemiology); Pseudomonas aeruginosa; Regression analysis; Respiratory intensive care unit; Respiratory tract; Risk analysis; Risk factors; Staphylococcus aureus infections; Studies; Surveillance; Teachers; Therapy; Urinary tract; China; Nosocomial infection; Respiratory intensive care unit; Risk factors
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-3772-2

To determine the epidemiology and risk factors for nosocomial infection (NI) in the Respiratory Intensive Care Unit (RICU) of a teaching hospital in Northwest China. An observational, prospective surveillance was conducted in the RICU from 2013 to 2015. The overall infection rate, distribution of infection sites, device-associated infections and pathogen in the RICU were investigated. Then, the logistic regression analysis was used to test the risk factors for RICU infection. In this study, 102 out of 1347 patients experienced NI. Among them, 87 were device-associated infection. The overall prevalence of NI was 7.57% with varied rates from 7.19 to 7.73% over the 3 years. The lower respiratory tract (43.1%), urinary tract (26.5%) and bloodstream (20.6%) infections accounted for the majority of infections. The device-associated infection rates of urinary catheter, central catheter and ventilator were 9.8, 7.4 and 7.4 per 1000 days, respectively.The most frequently isolated pathogens were Staphylococcus aureus (20.9%), Klebsiella pneumoniae (16.4%) and Pseudomonas aeruginosa (10.7%). Multivariate analysis showed that the categories D or E of Average Severity of Illness Score (ASIS), length of stay (10-30, 30-60, ≥60 days), immunosuppressive therapy and ventilator use are the independent risk factors for RICU infection with an adjusted odds ratio (OR) of 1.65 (95% CI: 1.15~2.37), 5.22 (95% CI: 2.63~10.38)), 2.32 (95% CI: 1.19~4.65), 8.93 (95% CI: 3.17~21.23), 31.25 (95% CI: 11.80~63.65)) and 2.70 (95% CI: 1.33~5.35), respectively. A relatively low and stable rate of NI was observed in our RICU through year 2013-2015. The ASIS-D、E, stay ≥10 days, immunosuppressive therapy and ventilator use are the independent risk factors for RICU infection.