Investigation on current status of prevention and control for hospital-associated infection related to continuous renal replacement therapy in ICUs of medical institutions in Beijing

OBJECTIVE To investigate the current status of continuous renal replacement therapy (CRRT) in 22 medical institutions under the jurisdiction of Beijing and their compliance with the core recommendations of the "Expert Consensus on Prevention Control of Hospital-associated Infection in Continuous Renal Replacement Therapy", providing evidence-based support for formulating targeted strategies to improve the quality of prevention and control for hospital-associated infection of CRRT.

METHODS A multi-center cross-sectional survey was conducted, data on the basic situation, institutional development, personnel management and infection control measures of intensive care unit (ICU) were collected by structured questionnaires. A database was established based on Epidata 3.1, and statistical analysis was performed with SPSS 19.0.

RESULTS CRRT was routinely provided in ICUs of 16 medical institutions, with an average catheterization duration of 6.29 days. The overall hospital-associated infection rate was 4.37%, and the incidence rate of CRRT catheter-related bloodstream infection was 0.73% (incidence rate per 1 000 catheter-days was 1.39‰). The investigation revealed significant deficiencies in the development of specialized infection control institutions and professional talent cultivation for CRRT. Medical institutions demonstrated high overall compliance with the core recommendations of the CRRT consensus. Compliance was positively correlated with the number of bedside haemofiltration apparatus in ICUs (r=0.476, P=0.021). The compliance rates for two key measures, ultrasound-guided venous puncture (50.00%) and the use of chlorhexidine-alcohol disinfectants (56.25%), urgently need improvement.

CONCLUSIONS It is both necessary and feasible to systematically enhance medical institutions′ compliance with consensus recommendations by establishing a specialized hospital-associated infection prevention and control institution, talent cultivation mechanism and quality control standards for CRRT based on regional realities.