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  • Title: [Nosocomial infections in a university hospital. Results of a prospective study of infections in a medical and surgical ward and a surgical intensive care unit].
    Author: Munzinger J, Bühler M, Geroulanos S, Lüthy R, von Graevenitz A.
    Journal: Schweiz Med Wochenschr; 1983 Dec 03; 113(48):1782-90. PubMed ID: 6658426.
    Abstract:
    The results of an 11-month pilot study of surveillance of nosocomial infections are reported. Prospective surveillance was performed by daily examination of the microbiology reports and daily visits by the infection control nurse to the ward for the review of charts and Kardex of all patients for detection of "infection clues". Work sheets were used to collect all data during the daily rounds. Infection rates were calculated by dividing the the total number of hospital-acquired infections by the total number of discharges during the surveillance period. Active surveillance was performed for 6 months in the surgical intensive care unit (SCIU), 5 months in the surgical ward (SW) and 9 months in the medical ward (MW). Of 1527 patients discharged from these wards, nosocomial infections developed in 158 patients (10.4%). The overall infection rate was 14% (214 nosocomial infections). The infection rate varied greatly from ward to ward due to different patient populations, invasive procedures and severity of underlying diseases. Incidence infection rates were 42.5% for the SICU, 19.6% for the SW and 4.1% for the MW. The major sites affected were surgical wounds (42%), urinary tract (23%), respiratory tract (19%) and bloodstream (8%). The major etiologic agents associated with these nosocomial infections were E. coli, Pseudomonas aeruginosa, enterococci and Staphylococcus aureus. Conclusions drawn from the results of surveillance are discussed. The major benefits of an effective surveillance program for nosocomial infections are (a) estimates of the endemic levels of nosocomial infection, (b) identification of the nosocomial pathogens commonly encountered within a given institution, (c) identification of risk factors and (d) prompt recognition of epidemics. These data provide the necessary basis for an effective infection control program.
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