Study of the incidence of nosocomial infection (Part I)
Evaluation of the incidence of nosocomial infection in one of the hospitals in Qom province (2007)
Mohaddseh Laripour (1)* (responsible author), Shirin Farsad (2)
1-Ph.D Student of Veterinary Mycology, Islamic Azad University, Science and Research Branch of Tehran
Postal address: Tehran-14566-14516, Fax: 66035031
The following article was published in Iranian Journal of Microbiology, Vol. 5, No 6, Autumn 2011.
Backgrounds and objectives
This study presents new information on the prevalence of microbial agents involved in hospital infections and its environmental factors affecting it in one of the hospitals in Qom province.
Each year, two million patients get infections in the hospitals. These infections called nosocomial infections include infections that are not present when the patient is admitted to the hospital or in the incubation period of the disease, cause the death of more than 19,000 people and impose a cost of more than $ 4.5 million a year.
Despite the fact that one-third of nosocomial infections are controlled, it is still considered seriously threatening in developed and developing countries.
Materials and methods:
In this descriptive prospective study, patients admitted to CCU, ICU, men and women surgery, nephrology, infants, infection and other wards were studied from March 21, 2007 to March 20, 2008.
The nurses in these wards filled in questionnaires with parameters such as surname, age, sex, hospitalization date, hospitalization ward, cause of hospitalization, incidence of nosocomial infection, place of incidence of nosocomial infection, date of incidence of nosocomial infections.
Then sampling was made from the site of infection and determined the agent type with examining the direct sample and the type of agent. Samples included phlegm, blood, urine, and ulcers.
Correlation test was used to analyze the results.
From the 21054 patients that were studied during one year, 105 patients with a mean age (16.64 ± 4.26) years and (age range from 30 days to 126 days) got nosocomial infections and 19 people died after 48 hours.
The number of hospitalized women was 50 and the number of men was 55. The incidence of infection was 35 in 10,000 patients. In this study, bacteria, viruses and fungi were isolated as secondary infectious agents in hospitalized patients.
In this study, bacteria isolated from patients with nosocomial infections are as follows:
From 37 people (35.2%): E.coli
From 14 people (33/13): Gram positive Cocci
From 12 people (11/42): Enterobacter
From 10 people (9/52): Alkaligenes
From 9 people (8/57): Klebsiella
From 8 people (7/61): Pseudomonas
Also, from 5 people (4/76): HBS Virus and from 4 people (3/80) HCV Virus were isolated.
Also, from 4 people (3/80) Candida albicans fungus and from 2 people (1/90) Aspergillus fungus were isolated.
The incidence density of infection in wards of ICU was 60, in the CCU 39.64, in the internal ward 37.71, in the surgical ward 28.67, in the orthopedic ward 14.19, in the pediatric ward 12.42, in the infection ward 9.77, in the heart ward 5.4, in the nephrology ward 4.67, and in the ear, throat and nose ward 2.44 patients in ten thousand patients a day.
According to correlation test, there was a significant relationship between age and increase in incidence of hospital infection (P <0.01). Also, with this test, there was no relationship between gender and the incidence of nosocomial infections (P <0.05).
According to the results, it was shown that the nosocomial infection with the specified factors is created in the range of 60-90 years old with the most frequent incidence due to immune system deficiencies, avitaminosis, diabetes, surgery, pneumonia and treatment staff (not observing the health by the doctor and nurse).
After this range, the most frequent incidence was observed in hospitalized infants. The relative frequency of nosocomial infections in this study was reported by urinary catheterization (42%), surgical wound (24%), lower respiratory tract (18%), blood flow (12%) and the other organs (14%). It shows that bacterial and fungus agents can lead to infection and even death, with the formation of biofilms on the equipment within the vessels and urinary catheterization. Therefore, it is essential to pay attention to the results of this research and to prevent the patients’ deterioration and their mortality with a low level of observance of the principles of prevention of these infections.
The results of this study, compared to other studies, show a lower incidence of nosocomial infections in this hospital that is due to the timely use of medical interventions, hand washing, health education, continuous monitoring of authorities, proper use of disposables, controlled use of antibiotics And proper care of the wounds of the surgery.
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