L. Frankart et al., Prevalence of nosocomial infections in a teaching hospital: distribution, predisposing factors and diagnostic pointers, SCHW MED WO, 128(50), 1998, pp. 1973-1983
Nosocomial infections are a major challenge for modern medicine and contrib
ute to increased resource use in health care systems. The first hospital-wi
de prevalence survey of nosocomial infections was conducted at the Universi
ty of Geneva Hospitals in 1994. At the time of the study, 16.9% of admitted
patients had nosocomial infections (168/994). Leading infection sites were
: urinary tract (30%), respiratory tract (17%), surgical wounds (12%) and b
loodstream (9.6%). Rates of infection varied between hospital wards: intens
ive care (21%), surgery (19%), rehabilitation (18%), internal medicine (13%
). However, the distribution of nosocomial infections varied according to s
urveillance and attribution rules. Optimal detection of nosocomial infectio
ns requires ward surveillance, including revision of microbiology, nursing
(Kardex) and medical records; the combination of fever above 38 degrees C,
prescription of antimicrobial agent(s), and positive microbiological record
s suggested the diagnosis of nosocomial infections in 95% of situations. Pr
iorities for infection control were derived from these results.