PROSPECTIVE MONITORING OF NOSOCOMIAL INFE CTIONS AT AN EMERGENCY DEPARTMENT IN SWITZERLAND

From May 1989 to February 1990, 1164 patients were followed in the Ser vice of Orthopaedic Surgery and Traumatology at the CHUV, for the deve lopment of nosocomial infections (N.I.), in particular postoperative w ound infections. Among them, 439 patients were treated conservatively and 725 underwent 833 operations. The global incidence of N.I. was 7.7 /100 admissions. Urinary tract infections represented 57% of all N.I., postoperative wound infections represented 21% (with 12% superficial and 9% deep infections), pneumonias represented 20% (5 deaths), bacter iemias represented 2% (1 death) of the cases. The rate of infections w as 1.1% for clean surgical interventions (n = 549), 0% for clean-conta mined operations (n = 87), 7.5% for contamined operations (n = 40), 22 .8% for dirty operations and 1.6% for unclassified operations (n = 122 ). Among the 19 postoperative wound infections, 6 were diagnosed after the patients were discharged. In conclusion, postoperative wound infe ctions constituted only 20% of all N.I. observed in the Service of Ort hopaedic Surgery and Traumatology and the rates of infection according to the types of interventions were low. On the other hand, 80% of the N.I. were observed at sites other then the wounds and were associated with a 0.5% mortality rate.