Changing patterns of hospital infections and antibiotic use. Prevalence surveys in a community hospital.

The results of a physician-performed prevalence survey of infections and antibiotic use at the Salt Lake City LDS Hospital in 1979 were compared with those from a previous survey in 1971. The overall prevalences and types of infections found in the two surveys were similar. Although Gram-negative bacilli accounted for 60% or more of all bacterial isolates from hospital-acquired infections in both surveys, Gram-negative bacilli other than Escherichia coli were more prevalent in the 1979 survey. An anticipated increase in numbers of critically ill patients resulting from our hospital's evolution as a regional tertiary care center was reflected by more patients with multiple sites of infection, with vascular or urinary catheters, and who were receiving multiple antibiotics. Use of antimicrobial agents increased from 23% to 37% of all surveyed patients and was attributed mainly to wide use of cephalosporins for prophylaxis in surgical patients.