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Open Access Highly Accessed Research article

Retrospective analysis of nosocomial infections in the intensive care unit of a tertiary hospital in China during 2003 and 2007

Ji-Guang Ding1, Qing-Feng Sun1*, Ke-Cheng Li2, Ming-Hua Zheng3, Xiao-Hui Miao4, Wu Ni4, Liang Hong1, Jin-Xian Yang1, Zhan-Wei Ruan5, Rui-Wei Zhou6, Hai-Jiao Zhou6 and Wen-Fei He7

Author Affiliations

1 Department of Infectious Diseases, The Third Affiliated Hospital to Wenzhou Medical College, Rui'an, Zhejiang, 325200, PR China

2 Department of Laboratories The Third Affiliated Hospital to Wenzhou Medical College, Rui'an, Zhejiang, 325200, PR China

3 Department of Infection and Liver Diseases, The First Affiliated Hospital to Wenzhou Medical College, Wenzhou, Zhejiang, 325000, PR China

4 Department of Infectious Diseases, Shanghai Changzheng Hospital, Shanghai, 200003, PR China

5 Intensive Care Unit, The Third Affiliated Hospital to Wenzhou Medical College, Rui'an, Zhejiang, 325200, PR China

6 Department of Hospital Infection Management, The Third Affiliated Hospital to Wenzhou Medical College, Rui'an, Zhejiang, 325200, PR China

7 Department of Natural Products Chemistry, School of Pharmacy, Wenzhou Medical College, Wenzhou, Zhejiang, 325035, PR China

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BMC Infectious Diseases 2009, 9:115  doi:10.1186/1471-2334-9-115

Published: 25 July 2009

Abstract

Background

Nosocomial infections are a major threat to patients in the intensive care unit (ICU). Limited data exist on the epidemiology of ICU-acquired infections in China. This retrospective study was carried out to determine the current status of nosocomial infection in China.

Methods

A retrospective review of nococomial infections in the ICU of a tertiary hospital in East China between 2003 and 2007 was performed. Nosocomial infections were defined according to the definitions of Centers for Disease Control and Prevention. The overall patient nosocomial infection rate, the incidence density rate of nosocomial infections, the excess length of stay, and distribution of nosocomial infection sites were determined. Then, pathogen and antimicrobial susceptibility profiles were further investigated.

Results

Among 1980 patients admitted over the period of time, the overall patient nosocomial infection rate was 26.8% or 51.0 per 1000 patient days., Lower respiratory tract infections (LRTI) accounted for most of the infections (68.4%), followed by urinary tract infections (UTI, 15.9%), bloodstream (BSI, 5.9%), and gastrointestinal tract (GI, 2.5%) infections. There was no significant change in LRTI, UTI and BSI infection rates during the 5 years. However, GI rate was significantly decreased from 5.5% in 2003 to 0.4% in 2007. In addition, A. baumannii, C. albicans and S. epidermidis were the most frequent pathogens isolated in patients with LRTIs, UTIs and BSIs, respectively. The rates of isolates resistant to commonly used antibiotics ranged from 24.0% to 93.1%.

Conclusion

There was a high and relatively stable rate of nosocomial infections in the ICU of a tertiary hospital in China through year 2003–2007, with some differences in the distribution of the infection sites, and pathogen and antibiotic susceptibility profiles from those reported from the Western countries. Guidelines for surveillance and prevention of nosocomial infections must be implemented in order to reduce the rate.