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Observational Study
. 2019 Feb 12;19(1):145.
doi: 10.1186/s12879-019-3772-2.

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

Linchuan Wang  1 , Kai-Ha Zhou  2 , Wei Chen  1 , Yan Yu  3 , Si-Fang Feng  4
Affiliations
Observational Study

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

Linchuan Wang et al. BMC Infect Dis. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Nosocomial infection; Respiratory intensive care unit; Risk factors.

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Conflict of interest statement

Ethics approval and consent to participate

The study was deemed exempt from review by the Ethics Committee of the First Affiliated Hospital of Xi’an Jiaotong University as routine data for clinical purpose were used and all the information of patients was kept confidential in the study.

Consent for publication

Not applicable.

Competing interests

LW, KHZ, WC, YY and SFF declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The distributions in each month of a RICU admission diagnosis, b patients admitted to the RICU and incidence rate of NI
Fig. 2
Fig. 2
The comparison of incidence rate of NI for a patients with different ASIS grades and length of RICU-stay, b patients with presence or absence of immunosuppressive therapy, endotracheal intubation, tracheotomy, urinary catheterization, central venous catheterization and ventilator
Fig. 3
Fig. 3
The adjusted odds ratio and 95% confidence intervals of risk factors for RICU infection by multivariate analysis
See this image and copyright information in PMC

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