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find Author "黄文治" 25 results
  • Trend of prevalence rate of nosocomial infection in West China Hospital of Sichuan University from 2012 to 2018

    ObjectiveTo investigate the prevalence rate of nosocomial infection in West China Hospital of Sichuan University and to analyze the implementation effect of nosocomial infection control measures, so as to provide reference for infection control.MethodsAn investigation of the prevalence rate of nosocomial infections was performed on patients who were admitted in West China Hospital of Sichuan University from 0:00-24:00 on a day of every late June from 2012 to 2018 by using bedside investigation in combination with inpatient medical record query, and the data was verified, summarized, and statistically analyzed by the professionals of Nosocomial Infection Management Department.ResultsFrom 2012 to 2018, the prevalence rates of nosocomial infections were 5.19%, 4.20%, 3.94%, 4.26%, 4.29%, 4.25%, and 2.97% in West China Hospital of Sichuan University, which tended to decline (χ2=32.826, P<0.001). There was no significant difference in annual total infection rate in the Department of Internal Medicine, however, the infection rate in the Department of Hematology tended to decline (χ2=6.127, P<0.05); in the Department of Surgical Medicine, the total infection rate tended to decline(χ2=18.721, P<0.001); in particular, the infection rate in the Department of Thoracic Surgery tended to decline(χ2=3.906, P<0.05); the annual difference in infection rate in the Intensive Care Unit (ICU) was not statistically significant. The key site of nosocomial infection was dominated by the lower respiratory tract, and the annual difference was not statistically significant. In particular, postoperative pneumonia has increased since 2014 (χ2=9.56, P=0.002). The nosocomial pathogens which had the highest constituent ratio over the years were Acinetobacter baumannii (in 2012, 2013, 2014, 2017, and 2018), Klebsiella pneumonia (in 2015), and Escherichia coli (in 2016). The annual difference in rate of antimicrobial use was not statistically significant(χ2=3.75, P=0.053), while the rate of antimicrobial use in the ICU tended to decline (χ2=30.42, P=0.000).ConclusionsThe prevalence rate of nosocomial infection in West China Hospital of Sichuan University tends to decline. However, sufficient attention still requires to be paid to lower respiratory tract infection, particularly for patients with postoperative pneumonia.

    Release date:2020-08-19 01:33 Export PDF Favorites Scan
  • Efficiency of hydrogen peroxide vapors in reducing multidrug-resistant organisms: a meta-analysis

    ObjectiveTo evaluate the efficiency of hydrogen peroxide vapor (HPV) in disinfecting multidrug-resistant organisms (MDROs).MethodsWe searched Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database for before-after studies or case-control studies or cohort studies evaluating efficiency of HPV and published from January 2010 to December 2020 (the time range was from January 2000 to December 2020 in the snowball searching). RevMan 5.4 and R 4.0.2 softwares were used for meta-analysis.ResultsA total of 9 studies were included, consisting of 8 before-after studies and 1 cohort study. Six studies evaluated positive rate of environmental samplings, meta-analysis revealed that HPV combined with manual cleaning disinfected the environment efficiently [relative risk (RR)=0.03, 95% confidence interval (CI) (0.01, 0.08), P< 0.000 01] and HPV was more efficient than manual cleaning [RR=0.04, 95%CI (0.02, 0.10), P< 0.000 01]. Three studies evaluated the hospital-acquired MDROs colonization/infection rates, and the results of the 3 studies were consistent, revealing that HPV could reduce hospital-acquired MDROs colonization/infection rates.ConclusionHPV is efficient in reducing MDROs contaminated surfaces and hospital-acquired infection rate.

    Release date:2021-04-15 05:32 Export PDF Favorites Scan
  • Application of interrupted time series analysis in hospital scientific research incentive

    The interrupted time series analysis was used to evaluate the incentive effect of the management methods of the SCI thesis fund for scientific research in West China Hospital of Sichuan University. We found an increase in number of the SCI papers and the growth rate after the adoption of scientific research incentive measures, indicating that the management methods of the SCI thesis fund had the incentive effect of scientific research. The interrupted time series analysis could be used in the incentive analysis of scientific research.

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  • Construction of a healthcare-associated infection management quality evaluation index system and an empirical study of comprehensive evaluation

    Objective To construct a quality evaluation index system for healthcare-associated infection (HAI) management, and conduct an empirical evaluation on the quality of HAI management in clinical departments. Methods The literature research method and panel discussion method were adopted to initially form the framework of HAI management quality evaluation index system, and the Delphi method and the analytic hierarchy process were used to establish the index system and determine the weights from January to December 2018. Eight comprehensive evaluation methods, such as osculating value method and technique for order preference by similarity to an ideal solution method, were used to evaluate the quality of HAI management in clinical departments of West China Hospital, Sichuan University in 2018. Kendall’s coefficient of concordance (W) was used to assess the consistency of the results. The clinical departments were ranked by the standardized total scores, which were the means of the normalized scores of the eight methods. Results A quality evaluation index system for HAI management with 3 first-level indicators and 15 second-level indicators was established finally. The results of the eight comprehensive evaluation methods for the quality evaluation of HAI management in 39 clinical departments of West China Hospital, Sichuan University were consistent (W=0.952, χ2=259.800, P<0.001). The standardized total score of Department 18 was 100, which ranked the first place. Conclusion The HAI management quality evaluation index system constructed in this study could be used in clinical departments to evaluate the quality of HAI management in combination with comprehensive evaluation methods.

    Release date:2022-04-25 03:47 Export PDF Favorites Scan
  • Epidemic analysis of notifiable infectious diseases from 2015 to 2020 in West China Hospital of Sichuan University

    ObjectiveTo analyze the epidemic characteristics of the notifiable infectious diseases in West China Hospital of Sichuan University, so as to guide the prevention, control and treatment of notifiable infectious diseases in the hospital and other medical institutions. MethodsDescriptive analysis was used to make statistics and analysis on the data of notifiable infectious diseases in West China Hospital of Sichuan University from 2015 to 2020, and the reporting situation, disease classification and transmission route were summarized. ResultsA total of 21 382 cases of notifiable infectious diseases with 32 types were reported. There was no class A infectious disease reported. There were 16 305 cases (76.26%) of class B infectious diseases and 5 077 cases (23.74%) of class C infectious diseases. The top 5 infectious diseases were pulmonary tuberculosis, influenza, syphilis, acquired immunodeficiency syndrome (including human immunodeficiency virus infection), and viral hepatitis type B. From the trend of the infectious disease reporting, the number of notifiable infectious diseases showed an upward trend from 2015 to 2020. ConclusionsThe report of notifiable infectious diseases in West China Hospital of Sichuan University from 2015 to 2020 mainly focuses on class B infectious diseases and class C infectious diseases. In the future, the prevention and control of infectious diseases should focus on respiratory infectious diseases, blood borne and sexually transmitted infectious diseases.

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  • Prognosis and influencing factors of bloodstream infection caused by carbapenem-resistant Pseudomonas aeruginosa: a cohort study

    Objective To explore the overall outcome and its factors of patients with carbapenem-resistant Pseudomonas aeruginosa bloodstream infection (CRPA-BSI). Methods A single-center, retrospective cohort study was carried out. The demographic and clinical data of all emergency patients and inpatients in West China Hospital of Sichuan University from 2017 to 2021 were collected. Firstly, the prognosis of patients with CRPA-BSI was compared with those with carbapenem-sensitive Pseudomonas aeruginosa bloodstream infection (CSPA-BSI). Then Cox regression was used to analyze the factors affecting the prognosis of CRPA-BSI patients. Results A total of 53 patients with CRPA-BSI and 175 patients with CSPA-BSI were enrolled, and they were 1∶1 matched according to the age-adjusted Charlson Comorbidity Index (aCCI) to control for confounding factors. When aCCI was similar, the incidence of poor prognosis in CRPA-BSI patients was significantly higher than that in CSPA-BSI patients [41.5% vs. 18.9%; relative risk=2.20, 95% confidence interval (CI) (1.16, 4.19), P=0.011]. The median length of hospital stay in the CRPA-BSI group was 3 d longer than that in the CSPA-BSI group but the difference was not statistically significant (29 vs. 26 d, P=0.388). With regard to prognostic factors, univariate Cox regression analyses showed that the highest temperature ≤39℃ (P=0.014), hepatobiliary and pancreatic diseases (P=0.011), days of central venous catheterization (P=0.025), days of indwelling urinary catheters (P=0.037), adjustment of medication duration according to drug sensitivity results (P=0.015) and Pitt bacteremia score (P=0.007) were related to the poor prognosis of CRPA-BSI patients. Multiple Cox regression analysis showed that hepatobiliary and pancreatic disease [hazard ratio (HR)=3.434, 95%CI (1.271, 9.276), P=0.015] and Pitt bacteremia score [HR=1.264, 95%CI (1.057, 1.510), P=0.010] were independently associated with poor outcome in CRPA-BSI patients. Conclusions The prognosis of CRPA-BSI patients is worsen than that of CSPA-BSI patients. Hepatobiliary and pancreatic diseases significantly increase the risk of poor outcome in CRPA-BSI patients. Pitt bacteremia score is a predictor of prognosis in patients with CRPA-BSI.

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  • Prevention and control strategies for carbapenem-resistant organism in medical institutions in China: a meta-analysis

    Objective To evaluate the efficiency of prevention and control strategies of carbapenem-resistant organism (CRO) in medical institutions in China using meta-analysis method. Methods PubMed, Embase, Medline (Ovid), Web of Science, China National Knowledge Infrastructure, Chongqing VIP and Wanfang Database were systematically searched for studies on CRO prevention and control in Chinese medical institutions from the establishment of databases to 2023 for meta-analysis. Results A total of 21 studies were included, consisting of 3 randomized controlled studies and 18 non-randomized controlled studies. The meta-analysis results showed that compared with standard prevention and control measures, strengthened intervention measures (including active screening, information-based transparent supervision mode, comprehensive intervention, and bundled prevention and control strategies) could effectively reduce the CRO infection rate [relative risk (RR)=0.40, 95% confidence interval (CI) (0.25, 0.65), P<0.05]. Proactive screening could effectively reduce the CRO infection rate [RR=0.52, 95%CI (0.30, 0.91), P<0.05] and carbapenem-resistant Enterobacteriaceae (CRE) infection rate [RR=0.47, 95%CI (0.24, 0.93), P<0.05]. Information-based transparent supervision could reduce the CRE infection rate by improving compliance with standard prevention and control measures [RR=0.42, 95%CI (0.28, 0.62), P<0.05]. Conclusions Compared with standard prevention and control measures, strengthened intervention measures can effectively reduce the risk of in-hospital transmission and infection of CRO. In clinical practice, bundled comprehensive intervention can be combined with information-based transparent supervision, and if necessary, proactive screening of CRO in high-risk populations should be carried out.

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  • 四川大学华西医院应对埃博拉出血热的管理及教育培训

    目的通过医院对埃博拉出血热的应急管理、针对埃博拉出血热的教育培训和考核,提高医务人员对埃博拉出血热的应对能力。 方法于2014年10月8日制定应急预案,开展教育培训并进行考核。 结果通过应急管理医院提高了埃博拉出血热防控能力,通过教育培训及考核提高了医务人员在个人防护用品使用方面的能力。 结论应对埃博拉出血热这类突发传染病,应通过应急管理和教育培训保证救治工作的开展。

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  • Targeted Surveillance and Risk Factors Analysis on Surgical Site Infection after Colorectal Resections

    ObjectiveTo investigate the risk factors for surgical site infection (SSI) in patients after colorectal surgery, in order to provide a basis for regulation and implementation of preventive measures against SSI. MethodsFrom February to December 2012, a targeted surveillance on surgical site infection of "colon resection" and "rectum resection" surgery patients in the Department of Gastrointestinal Surgery was carried out. We analyzed the monitoring data, and explored the occurrence of postoperative SSI. At the same time, by case-control study, both single and multiple regression logistic analyses were performed on the 12 variables such as hypertension, diabetes mellitus duration during operation, America Society of Anesthesiologists score, grade of incision and so on to analyze the risk factors for SSI. ResultsAmong the 535 patients who underwent colorectal resections, 44 had SSI with an infection rate of 8.22%. Multiple logistic regression analysis showed that the length of hospital stay[OR=1.070,95%CI(1.033,1.109), P<0.001]and emergency surgery[OR=6.320,95%CI(1.932,20.669),P=0.002] were independent risk factors for SSI after colorectal resections. ConclusionThere are many risk factors for SSI after colorectal surgery. Through the implementation of targeted surveillance, we can find the main risk factors, which provides a basis for the regulation and implementation of intervention measures against SSI.

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  • 综合干预措施对提高血液病房医护人员手卫生依从性的影响

    目的对血液科医护人员手卫生的依从性进行调查分析,通过综合干预措施提高医护人员的手卫生依从性。 方法由经过专门培训的医院感染管理科专职人员,在医护人员不知情的情况下,按照统一的调查表,观察医护人员手卫生的执行情况。2012年第1季度-第3季度为基线调查阶段,2012年第4季度-2013年第1季度为干预阶段,采取综合干预措施,2013年第2季度-第4季度为评估干预效果阶段。 结果干预前医护人员手卫生依从率为41.32%,干预后提高到70.41%,差异有统计学意义(P<0.01)。其中医生手卫生的依从率从31.58%提高到65.00%,护士手卫生的依从率从40.76%提高到74.64%。 结论综合干预措施可提高医护人员手卫生依从性。

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