[A two-year prospective survey on nosocomial infections]

A two-year randomized prospective survey on nosocomial infections in hospitalized patients of Hua Shan Hospital from 1985 to 1987 was carried out. Altogether 1,826 patients were enrolled in the study, the incidence of nosocomial infection being 13.1%. The incidence in dermatology ward was the highest (19.8%), then in order of frequency; medical ward 16.5%, surgical ward 14.8%, ward of neurology 13.7%, ward of neurosurgery 12.7% etc. Regarding the location of infection, lower respiratory tract infection was the most frequent (45.2%), followed by urinary tract infection (18%), wound infection (10%), biliary tract infection (7.5%), and bacteremia (5%). Out of 271 nosocomial strains of pathogens, 180 were Gram negative organisms (66.4%), among which P. aeruginosa accounted for 13.3%, K. pneumonia 12.2%, E. coli 8.9%, Acinetobacter sp 7.7%, and Enterobacter sp 7.7%. Gram positive cocci accounted for 22.9%; fungi 10.7%, candida sp. being the commonest. Results of bacterial susceptibility testing showed that the nosocomial strains were more resistant to commonly used antibiotics than the community strains, such as the resistance of E coli to ampicillin, P. aeruginosa to polymyxin B, S. aureus to lincomycin and gentamicin. Multiply factor analysis was done by Logistic regression model in 1,826 hospitalized patients, nine factors being statistically significant. Nosocomial infection is becoming increasingly important, it is imperative to have more intensive epidemiological surveillance data and to take effective control measures.