Evaluation of nosocomial infections in one of hospitals of Qom ,2008

Each year two million patients in the hospital were infected by nosocomial infections, that while person was being confined to bed into hospital does not exist, and kill more than 19,000 of patients and cost more than 5/4 million dollars in the year. Despite this fact that one third of nosocomial infections can be controlled, but it is still in developed and in developing countries a very serious risk. The aims of this study is explain new information regarding the prevalence of microbial and unmicrobial factors affecting in nosocomial infections in a hospital in Qom.

Int his study , confined to bed patients are considerd in ccu, Icu, men and women surgery, nephrology, neonatal and infectious part ,of 1/1/2008 to 01/01/2009. In this way ,the nurses were recorded information in questionnaire, including First & Last Name, age, sex, date of confined to bed, name of hospital part, kind of illness, kind of clinical symptom of nosocamial infection, hospital infection location, date of hospital infections. Then, this patients were sampled and samples were evaluated in microbiology laboratory. samples were including sputum, blood, urine and ulcerous. For analysis of the results was used of statistical tests as correlation.

Among 1043 patients studied in this one year, 105 patients with mean age of (64.16 > ± 26.4 ) years (ranging 30 days to 126 years) were diagnosed and 19 patients died after 48 hours of suffering to nosocamial infection. Number of women infectious confined to bed in to the hospital 50 persons and number of men was 55 patient. Overall incidence rate of NI was 35/10000 patients.In this study, bacteria, viruses and fungi were separated as factors causing NI in confined to bed patients. Regarding the etiology of infection were consist of: from 37 cases (85/33%) E.coli, from 14 cases (13/33)Gram positive Cocci, from 12 cases (42/11) Enterobacter, from 10 cases (52/9)Alkaligenes, from 9 (57/8) cases Klebsiella, from 8 cases (61/7)Pseudomonas were isolated . So, it were isolated of 5 (76/4) cases , HBS Virus and of four cases (80/3), HCV Virus. Also, Of 4 (80/3) cases ,Candida albicans and of two cases (90/1) Aspergillus were isolated. Incidence density in Icu was A86.60 «,in CCU f 39.64 f, in internal medicine ward was 37.71, in surgery was 28.67, in orthopedic ward was 14.19, in child ward 12.42, in infectious ward 9.77,in heart ward 5.4,in urology ward 4.67 and ENT ward 2.44 /10000 patients /day. According to test Correlation, there is significant relationship between increasing age and increasing incidence of nosocomial infection.(p<0.01) Also, this test showed that there is no relationship between sexuality and the prevalence of nosocomial infection. (P>0.05)

According to the results obtained, it was shown that certain factors of N I in the age range (60-90) years,and neonates, most occur due to immune system defects, avitaminosis, diabetes, surgeries, pneumonia and treatment of medical staff. Relative prevalence of nosocomial infection was through the urinary catheter (42%), surgical wound (24%), lower respiratory cannal(18 %), blood flow (12%) and remainder organs (14%). Therefore,attention to the results of this kind of researches and prevention of mortality of this patients to nosocamial infection is very essential.The result of in study indicate the lower frequency of NI in comparison with the national results.proper and timely use of medical intervention,hand washing especially for health personnel,health education ,continuous supervision, correct use of disposable equipments,controlled use of antibiotics good care of surgical wounds are the most important to be considered.