Epidemiology and control measures of nosocomial infection outbreaks in ICU in China

ObjectiveTo understand the epidemiological characteristics of outbreaks of nosocomial infection in intensive care units (ICUs) in hospitals in China and provide evidence for the prevention and control of nosocomial infection.

MethodsThrough literature retrieval, the outbreaks of nosocomial infection in ICUs in hospitals in China reported from January 2010 to December 2018 were analyzed retrospectively. Excel was used for the statistical analyses on hospital grade, outbreak time and place, involved person, infection site, risk factor, pathogen, transmission route and susceptible population.

ResultsA total of 45 outbreaks of nosocomial infection in ICUs were recorded, involving 359 patients, in which 32 (71.11%) occurred in grade Ⅲ (A) hospitals, 15 (33.33%) occurred in summer, 37 (82.23%) occurred in general ICUs and 35 (77.78%) had lower respiratory tract infections. Acinetobacter baumannii was major pathogen (65.11%, 28/43), followed by methicillin-resistant Staphylococcus aureus infection (11.63%, 5/43). In the pathogens, 93.02% (40/43) were multi-drug resistant. Most nosocomial infections were caused by indirect transmission, in which 21 were associated with contaminated medical devices, 16 with contaminated hands of medical staff, 15 with contamination of patient areas and 13 with contaminated medical textiles. The positive rate of conventional culture of environment samples was 10.76% (209/1 943).

ConclusionThe contact transmissions with multiple resources were dominant among the outbreaks of nosocomial infections in ICUs in China. It is necessary to pay close attention to multi-drug resistant pathogens and strengthen prevention and control of nosocomial infection outbreaks, and do not overly depend on the results of samples from environments.