Analysis of bacteriological distribution and correlation factors of nosocomial infection in the rehabilitation department

Abstract:

Objective：To examine bacteriological distribution and relative factors of nosocomial infection in the rehabilitation depart－ment of the First Affiliated Hospital of Chongqing Medical University. Methods：The clinical data from 156 patients with and 1 605 patients without nosocomial infection from January 2014 to December 2017 were collected by reviewing the patients’ medical histories and the Xinglin nosocomial infection monitoring system. The bacteriological distribution and relative factors of nosocomial infection were retrospectively analyzed. Results：The nosocomial infection rate in the rehabilitation department during the study period was 8.86%（2014：7.16%；2015：7.73%；2016：10.34%；and 2017：10.61%）. A total of 235 isolates were collected，including 178 gram-negative（G－） bacteria（75.74%），49 gram-positive（G+） bacteria （20.85%），and 8 fungi（3.40%）. The most common G－ pathogen was Escherichia coli（80，34.04%），and the most common G+ pathogen was Staphylococcus aureus（18，7.66%）. Among the 5 most common bacterial strains，Acinetobacter baumannii accounted for the highest proportion of multi-drug resistant bacteria（73.91%）. Urinary infection，respiratory infection，and blood infection accounted for 55.65%，20.87%，and 8.70% of cases，respectively. The main disease with nosocomial infection was stroke，accounting for 36.60% of cases. Patients with spinal cord injury had the highest nosocomial infection rate of 63.08%. Male sex（OR=2.105，95%CI=1.440-3.076，P=0.000），indwelling catheter（OR=4.629，95%CI=3.087-6.942，P=0.000），tracheotomy（OR=2.427，95%CI=1.293-4.557，P=0.006），and activities of daily living（ADL） score of <60（OR=13.455，95%CI=7.585-23.869，P=0.000） were factors that increased susceptibility to nosocomial infection in the department of rehabilitation. Indwelling gastric tube（OR=0.312，95%CI=0.166-0.587，P=0.000） might be a protective factor. Conclusions：The common pathogens were gram-negative bacteria，with a high proportion of multi-drug resistant bacteria. Urinary infections were most common. The main disease with nosocomial infection was stroke，while the patients with spinal cord injury had the highest nosocomial infection rate. Male sex，indwelling catheter，tra－cheotomy，and ADL score of <60 were the risk factors for nosocomial infection.