Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-29T17:26:16.106Z Has data issue: false hasContentIssue false
  • English
  • Français

Nosocomial Infections in a Rural Regional Hospital in a Developing Country: Infection Rates by Site, Service, Cost, and Infection Control Practices

Published online by Cambridge University Press:  02 January 2015

Fitzroy A. Orrett ,
Phyllis J. Brooks  and
Elizabeth G. Richardson
Fitzroy A. Orrett*
Affiliation:
Faculty of Medical Services, the Department of Pathology and Microbiology, the University of the West Indies, Republic of Trinidad and Tobago, West Indies
Phyllis J. Brooks
Affiliation:
St Augustine and Infection Control Department, San Fernando General Hospital, Republic of Trinidad and Tobago, West Indies
Elizabeth G. Richardson
Affiliation:
St Augustine and Infection Control Department, San Fernando General Hospital, Republic of Trinidad and Tobago, West Indies
*
Department of Pathology and Microbiology, Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad, West Indies
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To assess the prevalence of nosocomial infections at a rural government hospital from 1992 to 1995.

Design:

Retrospective review of data from 1992 to 1995 regarding rates of nosocomial infections, cost to government, and infection control practices.

Setting:

653-bed rural hospital providing primary and tertiary care.

Patients:

Patients admitted to the hospital between 1992 and 1995 who were found with hospital-acquired infections during their stay.

Interventions:

None.

Results:

Over the 4-year period, 7,158 nosocomial infections were identified from 72,532 patients (10.0/100 admissions). High nosocomial infection rates were found on the intensive-care unit (67/100 admissions), urology (30/100 admissions), neurosurgery (29.5/100 admissions), and newborn nursery (28.4/100 admissions). Urinary tract infections (4.1/100 admissions) accounted for most nosocomial infections (42%), followed by postoperative wound infections (26.8%) with a rate of 2.6/100 admissions. Nosocomial pneumonias and bloodstream infections also were common with 13.2% and 8.0%, respectively. The highest rates occurred on the intensive-care unit for both pneumonia (26.4/100 admissions) and bloodstream infection (7.0/100 admissions). The cost to the government for nosocomial infections was estimated at US $697,000 annually (US $1=$6 Trinidad and Tobago). Poor infection control practices, inadequate handwashing facilities, lack of supplies, and nonexistent garbage cans on most wards were quite evident.

Conclusions:

Strict adherence to proper infection control practices, such as handwashing techniques, and improvement of facilities are crucial steps in preventing cross-infections in the hospital environment. Implementing these measures may substantially reduce the massive drain on the hospital budget in treating nosocomial infections. The saved revenue could go toward improvement of ward facilities and reduction of over-crowding, thus further reducing cross-infection.

Type
The International Perspective
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 2 , February 1998 , pp. 136 - 140
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Martin, A, Pfaller, MA, Wenzel, RP. Coagulase-negative staphylococcal bacteremia: mortality and hospital stay. Ann Intern Med 1989;10:9–16.Google Scholar
2. McGowan, JE Jr. Cost and benefit in control of nosocomial infection: methods of analysis. Rev Infect Dis 1981;3:790–797.Google Scholar
3. Rose, R, Hunting, KJ, Townsend, TR, Wenzel, RP. Morbidity/mortality and economics of hospital-acquired bloodstream infections: a controlled study. South Med J 1977;70:1267–1269.Google Scholar
4. Haley, RW, Culver, DH, White, JW, Morgan, WM, Emori, TG. The nationwide infection rate: a new need for vital statistics. Am J Epidemiol 1985;121:206–215.Google Scholar
5. Martone, WJ, Jarvis, WR, Culver, DH, Haley, RW. Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett, JV, Brachmanled, PS, eds. Hospital Infections, 3rd ed. Boston, MA: Little Brown & Co; 1992:577–596.Google Scholar
6. Prabhakar, P, Raje, D, Castle, D, Rao, B, Fletcher, P, Duquesnay, D, et al. Nosocomial surgical infections: incidence and cost in a developing country. Am J Infect Control 1983;11:51–56.CrossRefGoogle Scholar
7. Central Statistics Office. Population and Vital Statistics Report. Port-of-Spain, Trinidad and Tobago: Ministry of Information; 1993.Google Scholar
8. Wenzel, RP, Osterman, CA, Hunting, KJ, Gwaltney, JM Jr. Hospital-acquired infections, I. Surveillance in a university hospital. Am J Epidemiol 1976;103:251–260.CrossRefGoogle ScholarPubMed
9. Fosi Mbantenkhu, J, Orrett, FA. Predisposition to Corynebacterium jeikeium infection in acute lymphoblastic leukemia. Med Pediatr Oncol 1994;22:350–354.CrossRefGoogle ScholarPubMed
10. Centers for Disease Control. National Nosocomial Infections Study. Fourth quarter, 1973. Washington, DC: US Department of Health, Education, and Welfare; 1974:5.Google Scholar
11. National Nosocomial Infection Surveillance System. Nosocomial infection rates for inter-hospital comparison: limitations and possible solutions. Infect Control Hosp Epidemiol 1991;12:609–621.Google Scholar
12. Wenzel, CP, Osterman, CA, Hunting, K. Hospital-acquired infections, II: infection rates by site, service and common procedures in a university hospital. Am J Epidemiol 1976;104:645–651.CrossRefGoogle ScholarPubMed
13. Orrett, FA, Premanand, N. Bacteriuria in out-patients with chronic indwelling urethral catheters. Medical Science Research 1993;21:333,334.Google Scholar
14. Craven, DE, Stegar, KA, Barber, TW. Preventing nosocomial pneumonia: state of the art and perspectives for the 1990s. Am J Med 1991;19(suppl 3B):44S–53S.Google Scholar
15. Mayhall, CG. Surgical infections including burns. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infections. 2nd ed. Baltimore, MD: William & Watkins Co; 1993:614–664.Google Scholar
16. Classen, DC, Evans, RS, Pestotnik, SL, Horn, SD, Menlove, RL, Burke, JP. The timing of prophylactic administration of antibiotics and the risk of surgical wound infections. N Engl J Med 1992;326:281–286.Google Scholar
17. Centers for Disease Control. Isolation Techniques for Use in Hospitals, 2nd ed. Washington, DC: Government Printing Office; 1975.Google Scholar