Orrett F A, Brooks P J, Richardson E G
Faculty of Medical Services, the Department of Pathology and Microbiology, University of the West Indies, St Augustine, Republic of Trinidad and Tobago.
Infect Control Hosp Epidemiol. 1998 Feb;19(2):136-40. doi: 10.1086/647781.
To assess the prevalence of nosocomial infections at a rural government hospital from 1992 to 1995.
Retrospective review of data from 1992 to 1995 regarding rates of nosocomial infections, cost to government, and infection control practices.
653-bed rural hospital providing primary and tertiary care.
Patients admitted to the hospital between 1992 and 1995 who were found with hospital-acquired infections during their stay.
None.
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.
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 overcrowding, thus further reducing cross-infection.
评估1992年至1995年一家农村公立医院的医院感染患病率。
回顾性分析1992年至1995年有关医院感染率、政府成本及感染控制措施的数据。
一家拥有653张床位、提供初级和三级护理的农村医院。
1992年至1995年间入院且在住院期间被发现有医院获得性感染的患者。
无。
在这4年期间，从72532名患者中识别出7158例医院感染（每100例入院患者中有10.0例）。重症监护病房（每100例入院患者中有67例）、泌尿外科（每100例入院患者中有30例）、神经外科（每100例入院患者中有29.5例）和新生儿病房（每100例入院患者中有28.4例）的医院感染率较高。尿路感染（每100例入院患者中有4.1例）占大多数医院感染（42%），其次是术后伤口感染（26.8%），发生率为每100例入院患者中有2.6例。医院获得性肺炎和血流感染也很常见，分别占13.2%和8.0%。肺炎（每100例入院患者中有26.4例）和血流感染（每100例入院患者中有7.0例）在重症监护病房的发生率最高。医院感染给政府造成的成本估计为每年69.7万美元（1美元=6特立尼达和多巴哥元）。大多数病房感染控制措施不力、洗手设施不足、物资缺乏且没有垃圾桶的情况十分明显。
严格遵守正确的感染控制措施，如洗手技术，并改善设施，是预防医院环境中交叉感染的关键步骤。实施这些措施可能会大幅减少医院治疗医院感染的预算大量消耗。节省下来的资金可用于改善病房设施和减少过度拥挤，从而进一步减少交叉感染。
