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Variation in nosocomial infection prevalence according to patient care setting:a hospital-wide survey

Herrault, Pascale
Published in The Journal of hospital infection. 2001, vol. 48, no. 1, p. 27-32
Abstract A study was performed to estimate the prevalence of nosocomial infections (NI) and assess differences between medical care settings in one hospital complex. A seven-day period-prevalence survey was conducted in May 1998 in a large primary and tertiary healthcare centre in Geneva, Switzerland, that included all patients in acute, sub-acute and chronic care settings. Variables included demography, exposure to invasive devices and antibiotics, surgical history, and patients' localization. Overall prevalence of NI was 11.3% (acute, 8.4%; sub-acute, 11.4%; chronic care setting, 16.4%) in the 1928 patients studied, and ranged from 0% in ophthalmology to 23% in critical care units. Odds of infection in sub-acute and chronic care settings were significantly higher than in the acute care setting even after adjustment for case-mix [OR, 2.59; 95% confidence interval (CI(95)) 1.53-4.41; and OR, 2.34; Cl(95)1.38-3.95, respectively]. As a distinct group, patients in the geriatric location (belonging to the sub-acute care setting) showed a significant proportion of urinary (39%) and respiratory (21%) tract infections, contrasting with a relatively low exposure to urinary catheters (6.1%) and orotracheal intubation (0%). In conclusion, sub-acute and chronic care settings are associated with high infection prevalence even after case-mix adjustment. Prevalence studies are an easy surveillance tool that can be exploited further by analysing data according to hospital care settings to identify high-risk areas.
Keywords Acute Disease/ therapyAdolescentAdultAgedAged, 80 and overBacterial Infections/epidemiology/ etiologyCandidiasis/epidemiology/ etiologyChi-Square DistributionChildChild, PreschoolChronic Disease/ therapyCross Infection/epidemiology/ etiologyDiagnosis-Related Groups/classification/statistics & numerical dataHospital UnitsHospitals, TeachingHumansInfantInfant, NewbornInfection ControlLength of Stay/statistics & numerical dataLogistic ModelsLong-Term CareMiddle AgedPrevalenceRisk FactorsSubacute CareSwitzerland/epidemiology
PMID: 11358468
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Research groups Epidémiologie et contrôle de la résistance aux antibiotiques (866)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
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SAX, Hugo et al. Variation in nosocomial infection prevalence according to patient care setting:a hospital-wide survey. In: The Journal of hospital infection, 2001, vol. 48, n° 1, p. 27-32. doi: 10.1053/jhin.2001.0961 https://archive-ouverte.unige.ch/unige:7566

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Deposited on : 2010-06-21

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