ObjectiveTo explore the risk factors of community-acquired urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBLs-producing Escherichia coli). MethodsProspective and retrospective investigation methods were combined, to investigate the hospitalized patients diagnosed with community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli in the Second Affiliated Hospital of Fujian Medical University during July 2012 to December 2014. Statistical analysis was performed using SPSS 19.0 software. The potential risk factors were analyzed by chi-square test or Fisher exact probability method, then, factors with statistical significance identified by single factor analysis were further analyzed by non-conditional logistic regression. ResultsA total of 106 patients were included and divided into a ESBLs group (68 cases) and a control group (38 cases) according to the drug sensitivity test results. The results of single factor analysis indicated: there were significant differences between the ESBLs group and the control group in the use of antibiotics within three months before admission (χ2=11.292, P=0.001), the use of third generation cephalosporin (χ2=11.033, P=0.001), more than three kinds of diseases that could cause urinary tract obstruction (χ2=16.464, P=0.000), anemia (χ2=5.956, P=0.015), indwelling catheter (χ2=6.695, P=0.010), urinary system operations (χ2=9.730, P=0.002). The results of further non-conditional logistic regression analysis showed that more than three kinds of diseases that could cause urinary tract obstruction (OR=14.675, 95%CI 2.699 to 79.796, P=0.002), anemia (OR=7.976, 95%CI 1.785 to 35.632, P=0.007), the use of antibiotics within three months before admission (OR=7.057, 95%CI 1.597 to 31.175, P=0.010), the use of third generation cephalosporin (OR=6.344, 95%CI 1.145 to 35.146, P=0.034) and indwelling catheter (OR=3.844, 95%CI 1.058 to 13.967, P=0.041) were independent risk factors of community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli. ConclusionThe risk factors of community-acquired urinary tract infections caused by ESBLs-producing Escherichia coli include more than three kinds of diseases that could cause urinary tract obstruction, anemia, the use of antibiotics within three months before admission, the use of third generation cephalosporin, and indwelling catheter. The use of antibiotics, especially the third generation cephalosporin, should be strictly controlled, the time of indwelling catheter should be reduced, and the anemia should be corrected, in order to reduce the incidence of community-acquired urinary tract infections caused by ESBLsproducing Escherichia coli.
ObjectiveTo explore the risk factors for multiple nosocomial infection in adult hospitalized patients, so as to provide references for the control of nosocomial infection. MethodsThe clinical data of adults hospitalized patients with nosocomial infection in the Second Affiliated Hospital of Fujian Medical University during Jan. 2015 to Dec. 2015 were collected, and the susceptible factors of multiple nosocomial infections referencing to the single nosocomial infection were analyzed. Results1226 cases (1368 case-times) of nosocomial infection were found and the infection rate and the case-time infection rate were 2.24% and 2.49%, respectively. Single factor analysis results showed that the top four risk factors of multiple nosocomial infection included hospital stay ≥30 days (25.5%), first infection time ≥30 days (23.2%), incision type Ⅲ (16.7%), and surgery (13.4%). Logistic regression analysis result showed, after adjusting the influence of age and gender, longer hospital stay was the independent risk factor of multiple nosocomial infection referencing to single nosocomial infection (OR=3.475, 95%CI 2.545 to 4.745). ConclusionLonger hospital stay is the independent risk factor of multiple nosocomial infection of adult hospitalized patients. Measures should be taken to shorten the length of stay in hospital and reduce the exposure to the high-risk environment, so as to reduce the incidence of multiple nosocomial infection.
Objective To evaluate the effect of active screening and intervention of multidrug-resistant organisms (MDROs) on control nosocomial infection in the general intensive care unit (ICU). Methods A non-concurrent control trial was conducted in patients hospitalized in the ICU for more than 24 hours in the Second Affiliated Hospital of Fujian Medical University. Patients underwent active screening of MDROs for nasal vestibular swab, throat swab and rectal swab combined with further intensive intervention for patients with positive screening result during Sept. 2014 to Aug. 2015 were included as an intervention group, patients only underwent active screening during Sept. 2013 to Aug. 2014 were included as a screening group, and patients without undergoing active screening during Sept. 2012 to Aug. 2013 were as a control group. SPSS 19.0 software was used to compare the hospital infection rate and the infection rate of MDROs among the three groups. Results A total of 1 773 patients were included, of which 655 patients were in the intervention group, 515 patients were in the screening group, and 603 patients were in the control group. The difference of hospital infection rates among the three groups was statistically significant (χ2=21.087, P < 0.001), and further pairwise comparison results showed that the intervention group was lower than the screening group (χ2=5.891, P=0.015), and the screening group was lower than the control group (χ2=4.259, P=0.039). The adjustment daily infection rate of the intervention group, screening group and control group were 6.69‰, 10.88‰, and 15.39‰, respectively. The difference of MDROs hospital infection rates among the three groups was statistically significant (χ2=21.039, P < 0.001), and further pairwise comparison results showed that the intervention group was lower than the screening group (χ2=5.936, P=0.015), and the screening group was lower than the control group (χ2=5.798, P=0.016). The MDROs thousand daily infection rate of the intervention group was lower than that of the screening group (3.90‰ vs. 7.30‰, χ2=5.999, P=0.014). Conclusion The active screening plus intensive intervention of MDROs can effectively reduce the incidence rates of nosocomial infections and MDROs infections in ICU.