Kamp-Hopmans Titia E M, Blok Hetty E M, Troelstra Annet, Gigengack-Baars Ada C M, Weersink Annemarie J L, Vandenbroucke-Grauls Christina M J E, Verhoef Jan, Mascini Ellen M
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, HP G04.614, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Infect Control Hosp Epidemiol. 2003 Aug;24(8):584-90. doi: 10.1086/502258.
To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections.
Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and vascular, thoracic, orthopedic, and general gynecologic and gynecologic-oncologic surgery of the University Medical Center Utrecht, the Netherlands. Data were collected from patients with and without infections, using criteria of the Centers for Disease Control and Prevention.
The infection control team recorded 648 hospital-acquired infections affecting 550 (14%) of 3,845 patients. The incidence density was 17.8 per 1,000 patient-days. Patients with hospital-acquired infections were hospitalized for 19.8 days versus 7.7 days for patients without hospital-acquired infections. Prolongation of stay among patients with hospital-acquired infections may have resulted in 664 fewer admissions due to unavailable beds. Different specialties were associated with different infection rates at different sites, requiring a tailor-made approach. Interventions were recommended for respiratory tract infections in the thoracic surgery ward and for surgical-site infections in the orthopedic and gynecologic surgery wards.
Surveillance in four surgical wards showed that each had its own prominent infection, risk factors, and indications for specific recommendations. Because prospective surveillance requires extensive resources, we considered a modified approach based on a half-yearly point-prevalence survey of hospital-acquired infections in all wards of our hospital. Such surveillance can be extended with procedure-specific prospective surveillance when indicated.
确定医院获得性感染的发病率，并制定预防措施以降低医院获得性感染的风险。
在荷兰乌得勒支大学医学中心的普通外科、血管外科、胸外科、骨科、普通妇科和妇科肿瘤外科病房进行了为期5年的医院获得性感染前瞻性监测。根据疾病控制与预防中心的标准，收集了感染患者和未感染患者的数据。
感染控制团队记录了648例医院获得性感染，累及3845例患者中的550例（14%）。发病密度为每1000患者日17.8例。医院获得性感染患者的住院时间为19.8天，而未发生医院获得性感染的患者为7.7天。医院获得性感染患者住院时间的延长可能导致因床位不足而减少664例入院。不同专科在不同部位的感染率不同，需要采取量身定制的方法。建议对胸外科病房的呼吸道感染以及骨科和妇科手术病房的手术部位感染进行干预。
对四个外科病房的监测表明，每个病房都有其突出的感染、危险因素以及具体建议的指征。由于前瞻性监测需要大量资源，我们考虑基于对我院所有病房医院获得性感染进行半年一次的现患率调查的改良方法。如有指征，这种监测可通过特定手术的前瞻性监测加以扩展。
