Targeted surveillance of nosocomial infection in intensive care units of 176 hospitals in Jiangsu province, China

Background: Nosocomial infections (NIs) impact care and costs in hospitals across the globe. There are few data on targeted surveillance of NI in intensive care units (ICUs), and data specific to the risk factors for NI are especially limited. Methods: One hundred and seventy-six secondary and tertiary hospitals performed NI targeted surveillance in their ICUs. The data were collected and summarized by Minke software, then fed back once per quarter. Findings: The incidence of NI appeared to decrease, and the incidence of NI per 1000 patient-days and adjusted incidence were 25.63 parts per thousand and 7.41 parts per thousand in 2010, and 9.73 parts per thousand and 2.76 parts per thousand in 2015, respectively. The NI incidence in general hospitals was higher than in specialized hospitals. The incidence of central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) appeared to decrease, and the incidence of ventilator-associated pneumonia (VAP) decreased markedly from 20.33 parts per thousand to 2.76 parts per thousand. There was no statistically significant difference among ICUs. The six most frequently found pathogen-caused NIs were Acinetobacter baumannii (AB), Klebsiella pneumoniae (KP), Pseudomonas aeruginosa (PA), Staphylococcus aureus, Candida albicans, and Escherichia coli (E. coli). The isolation rate of carbapenem-resistant Gram-negative bacilli were carbapenem-resistant AB 80.53%, carbapenem-resistant PA 39.94%, carbapenem-resistant KP (CRKP) 24.86%, and carbapenem-resistant E. coli 9.23%. The isolation rate of meticillin-resistant S. aureus (MRSA) was 66.30%. The increasing trend of CRKP was statistically significant as analysed by the regression model. Conclusion: The incidences of VAP, CAUTI, and CLABSI were high in ICUs, and multidrug-resistant organisms were the primary pathogens of NI. The implementation of targeted surveillance may determine the risk factors of NI so that effective intervention measures can be taken to reduce the incidence of NI in ICU patients. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.