Objective To investigate nosocomial infection rate in Intensive Care Unit (ICU), its risk factors and the pathogenic characteristics of multidrug-resistant bacteria through targeted monitoring, in order to provide scientific references for reducing nosocomial infection. Methods Targeted monitoring was performed on the patients who were admitted to the comprehensive ICU between July 2014 and June 2016. Results Nosocomial infection occurred in 312 of the 4 991 patients. The case infection rate was 6.25%, and case infection rate per day was 19.03‰. After the adjustment, the case infection rate per day was 6.77‰. The ventilator-associated pneumonia infection accounted for 30.78‰; catheter-related bloodstream infection occupied 0.30‰; and catheter-associated urinary tract infection accounted for 0.27‰. The respiratory tract was the major part of nosocomial infection, accounting for 90.38%. Gram-negative bacilli were the major bacteria accounting for 92.74%, in whichAcinetobacter baumannii accounted for 36.29%. Conclusions Through targeted monitoring to keep abreast of the current situation of nosocomial infection in ICU, management and interventions can be targeted. It is an important way to reduce nosocomial infection in ICU.
ObjectiveTo retrospectively analyze the causes and risk factors of unplanned extubation (UE) in cancer patients during peripherally inserted central catheter (PICC) retention, so as to provide references for effectively predicting the occurrence of UE. Methods27 998 cancer patients who underwent PICC insertion, maintenance and removal in the vascular access nursing center of our hospital from January 2016 to June 2023 were retrospectively analyzed. General information, catheterization information, and maintenance information were collected. The Chi-squared test was used for univariate analysis, multivariate analysis was used by binary unconditional logistic regression. They were randomly divided into modeling group and internal validation group according to the ratio of 7∶3. The related nomogram prediction model and internal validation were established. ResultsThe incidence of UE during PICC retention in tumor patients was 2.80% (784/27 998 cases). Univariate analysis showed that age, gender, diagnosis, catheter retention time, catheter slipping, catheter related infection, catheter related thrombosis, secondary catheter misplacement, dermatitis, and catheter blockage had an impact on UE (P<0.05). Age, diagnosis, catheter retention time, catheter slipping, catheter related infection, catheter related thrombosis, secondary catheter misplacement, and catheter blockage are independent risk factors for UE (P<0.05). Based on the above 8 independent risk factors, a nomogram model was established to predict the risk of UE during PICC retention in tumor patients. The ROC area under the predicted nomogram was 0.90 (95%CI 0.89 to 0.92) in the modeling group, and the calibration curve showed good predictive consistency. Internal validation showed that the area under the ROC curve of the prediction model was 0.91 (95%CI 0.88 to 0.93), and the trend of the prediction curve was close to the standard curve. ConclusionPatients aged ≥60 years, non chest tumor patients, catheter retention time (≤6 months), catheter slipping, catheter related infections, catheter related thrombosis, secondary catheter misplacement, and catheter blockage increase the risk of UE. The nomogram model established in this study has good predictive ability and discrimination, which is beneficial for clinical screening of patients with different degrees of risk, in order to timely implement targeted prevention and effective treatment measures, and ultimately reduce the occurrence of UE.