Nosocomial surgical infections: incidence and cost.

The data reported in this article support the findings of Dr. Altemeier; that is, infections among surgical patients remain a serious problem today. Urinary tract infections account for approximately 40 per cent of nosocomial infections among surgical patients. Surgical wound and skin infections account for one third of the nosocomial infections among surgical patients. Rates for wound infections rise with age, with increased length of hospitalization before surgery, and with increased duration of surgery. They are higher for patients who have an infection at a distant site and for those who have the more hazardous surgical procedures as determined by risk categories. Gram-negative organisms are more prevalent than gram-positive organisms. A nosocomial surgical wound infection lengthens the hospitalization by an average of 7.4 days and raises the cost of hospitalization by more than 800 dollars. Further analysis of the data is necessary in order to identify the risk factors likely to be most helpful in determining which patients are at increased risk of acquiring a nosocomial infection. Only when these factors are identified can the most direct and effective contact and preventive measures be implemented.