Hopmans T E M, Blok H E M, Troelstra A, Bonten M J M
Hospital Hygiene and Infection Prevention, Department of Medical Microbiology, University Medical Center Utrecht, The Netherlands.
Infect Control Hosp Epidemiol. 2007 Apr;28(4):459-65. doi: 10.1086/512640. Epub 2007 Mar 16.
To monitor hospital-wide trends in the prevalence of hospital-acquired infections (HAIs) in order to identify areas where the risk of infection is increasing.
Successive surveillance surveys were conducted twice yearly, from November 2001 until May 2004, to determine the prevalence of HAIs at 2 Dutch hospitals, using Centers for Disease Control and Prevention criteria.
In all, 340 HAIs were observed in 295 (11.1%) of 2,661 patients surveyed. The overall prevalence per survey varied from 10.2% to 15.6%, with no significant differences between successive surveys. In the surgical department, the prevalence of HAIs increased from 10.8 cases per 100 surgeries in November 2001 to 20.4 cases per 100 surgeries in May 2002. Further analysis revealed a high prevalence of surgical site infection among patients who had an orthopedic procedure performed. In the neurology-neurosurgery department, the prevalence increased from 13.0 cases per 100 patients in May 2002 to 26.6 cases per 100 patients in May 2003 and involved several types of infection. Further analysis retrieved exceptionally high incidences of infections associated with cerebrospinal fluid drainage. Specific infection control interventions were developed and implemented in both departments. The total cost of the surveys was estimated to be euro9,100 per year.
Successive performance of surveillance surveys is a simple and cheap method to monitor the prevalence of infection throughout the hospital and appeared instrumental in identifying 2 departments with increased infection rates.
监测全院范围内医院获得性感染(HAIs)的流行趋势,以确定感染风险增加的领域。
从2001年11月至2004年5月,每年进行两次连续监测调查,使用美国疾病控制与预防中心的标准来确定两家荷兰医院的HAIs患病率。
在总共调查的2661名患者中,295名(11.1%)患者发生了340起HAIs。每次调查的总体患病率在10.2%至15.6%之间,连续调查之间无显著差异。在外科,HAIs的患病率从2001年11月每100例手术中的10.8例增加到2002年5月每100例手术中的20.4例。进一步分析显示,接受骨科手术的患者手术部位感染患病率很高。在神经科-神经外科,患病率从2002年5月每100例患者中的13.0例增加到2003年5月每100例患者中的26.6例,涉及多种类型的感染。进一步分析发现与脑脊液引流相关的感染发生率异常高。两个科室都制定并实施了具体的感染控制干预措施。调查的总成本估计为每年9100欧元。
连续进行监测调查是一种简单且廉价的方法,可用于监测全院范围内的感染患病率,并且在识别出两个感染率增加的科室方面似乎发挥了作用。