2010, Number 6
<< Back Next >>
salud publica mex 2010; 52 (6)
Surveillance of nosocomial infections in a Mexican community hospital. How are we doing?
García-García L, Jiménez-Corona ME, Ramírez-López LE, Báez-Saldaña R, Ferreyra-Reyes L, Ferreira-Guerrero E, Cano-Arellano B, Cruz-Hervert P, Téllez-Vázquez NA, Verduzco-Rodríguez L, Jaramillo-Cosme Y, Luna-Téllez E, Ponce de León-Rosales S
Language: English
References: 30
Page: 511-516
PDF size: 134.70 Kb.
ABSTRACT
Objective. To compare the nosocomial infection (NI) rate obtained from a retrospective review of clinical charts with that from the routine nosocomial infection surveillance system in a community hospital.
Material and Methods. Retrospective review of a randomized sample of clinical charts. Results were compared to standard surveillance using crude and adjusted analyses.
Results. A total of 440 discharges were reviewed, there were 27 episodes of NIsamong 22 patients. Cumulated incidence was 6.13 NI per 100 discharges. Diarrhea, pneumonia and peritonitis were the most common infections. Predictors of NI by Cox regression analysis included pleural catheter (HR 16.38), entry through the emergency ward, hospitalization in the intensive care unit (HR 7.19), and placement of orotracheal tube (HR 5.54).
Conclusions. Frequency of NIs in this community hospital was high and underestimated. We identified urgent needs in the areas of training and monitoring.
REFERENCES
Mayon-White RT, Ducel G, Kereselidze T, Tikomirov E. An international survey of the prevalence of hospital-acquired infection. J Hosp Infect 1988;11 Suppl A:43-8.
Ponce-de-Leon S. The needs of developing countries and the resources required. J Hosp Infect 1991;18 Suppl A:376-81.
Apisarnthanarak A, Fraser VJ. Feasibility and efficacy of infection-control interventions to reduce the number of nosocomial infections and drugresistant microorganisms in developing countries: what else do we need? Clin Infect Dis 2009;48(1):22-4.
Orrett FA, Brooks PJ, Richardson EG. Nosocomial infections in a rural regional hospital in a developing country: infection rates by site, service, cost, and infection control practices. Infect Control Hosp Epidemiol 1998;19(2):136-40.
Haley RW, Culver DH, White JW, Morgan WM, Emori TG, Munn VP, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121(2):182-205.
Haley RW, Schaberg DR, McClish DK, Quade D, Crossley KB, Culver DH, et al. The accuracy of retrospective chart review in measuring nosocomial infection rates. Results of validation studies in pilot hospitals. Am J Epidemiol 1980;111(5):516-33.
Secretaría de Salud. Norma Oficial Mexicana NOM-026-SSA2-1998, para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales. Diario Oficial de la Federación, March 30, 2000.
Clasificación Estadística Internacional de Enfermedades y problemas relacionados con la salud. Décima revisión. Washington DC: World Health Organizacion/Pan American Health Organization, 1995.
Secretaría de Salud. Norma Oficial Mexicana NOM-025-SSA2-1994, para la prestación de servicios de salud en unidades de atención integral hospitalaria médico-psiquiátrica. Diario Oficial de la Federación, November 16,1995.
Guerrant RL, Hughes JM, Lima NL, Crane J. Diarrhea in developed and developing countries: magnitude, special settings, and etiologies. Rev Infect Dis 1990;12 Suppl 1:S41-50.
Gray FJ. Surgical wound infection in a developing country-Papua New Guinea. P N G Med J 1974;17(4):373-8.
Ibarra-Colado JE, Mendez-Hernandez S, Cortes-Castillo LF. [Hospital infections in children in a general hospital]. Bol Med Hosp Infant Mex 1991;48(11):820-5.
Zaidi M, Ponce de Leon S, Ortiz RM, Ponce de Leon S, Calva JJ, Ruiz-Palacios G, et al. Hospital-acquired diarrhea in adults: a prospective case-controlled study in Mexico. Infect Control Hosp Epidemiol 1991;12(6):349-55.
Hall G, Bogan A, Dreis S, Duffy A, Greene S, Kelley K, et al. New directions in peritoneal dialysis patient training. Nephrol Nurs J 2004;31(2):149-54, 159-63.
Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect Control Hosp Epidemiol 2000;21(8):510-5.
Rosenthal VD, Guzman S, Pezzotto SM, Crnich CJ. Effect of an infection control program using education and performance feedback on rates of intravascular device-associated bloodstream infections in intensive care units in Argentina. Am J Infect Control 2003;31(7):405-9.
Rosenthal VD, Guzman S, Safdar N. Effect of education and performance feedback on rates of catheter-associated urinary tract infection in intensive care units in Argentina. Infect Control Hosp Epidemiol 2004;25(1):47-50.
Weber DJ, Raasch R, Rutala WA. Nosocomial infections in the ICU: the growing importance of antibiotic-resistant pathogens. Chest 1999;115(3 Suppl):34S-41S.
Velasco E, Thuler LC, Martins CA, Dias LM, Goncalves VM. Nosocomial infections in an oncology intensive care unit. Am J Infect Control 1997;25(6):458-62.
Nafzinger DA. Nosocomial pneumonia. In: Wenzel RP, editor. Prevention and control of nosocomial infections. 4 ed. Philadelphia: Lippincott Williams & Williams, 1997:312-327.
Nosocomial infection rates for interhospital comparison: limitations and possible solutions. A Report from the National Nosocomial Infections Surveillance (NNIS) System. Infect Control Hosp Epidemiol 1991;12(10):609-21.
Jarvis WR. Selected aspects of the socioeconomic impact of nosocomial infections: morbidity, mortality, cost, and prevention. Infect Control Hosp Epidemiol 1996;17(8):552-7.
Ponce De Leon Rosales S. [Intrahospital infections and quality of medical care. Is it possible to save in health?]. Salud Publica Mex 1991;33(1):3-8.
Rangel-Frausto MS, Morales-Garcia D, Baez-Martinez R, Ibarra- Blancas J, Ponce de Leon-Rosales S. [Evaluation of a nosocomial infection surveillance program]. Salud Publica Mex 1999;41 Suppl 1:S59-63.
Navarrete-Navarro S, Armengol-Sanchez G. [Secondary costs due to nosocomial infections in 2 pediatric intensive care units]. Salud Publica Mex 1999;41 Suppl 1:S51-8.
Emori TG, Edwards JR, Culver DH, Sartor C, Stroud LA, Gaunt EE, et al. Accuracy of reporting nosocomial infections in intensive-care-unit patients to the National Nosocomial Infections Surveillance System: a pilot study. Infect Control Hosp Epidemiol 1998;19(5):308-16.
Pottinger JM, Herwaldt LA, Peri TM. Basics of surveillance--an overview. Infect Control Hosp Epidemiol 1997;18(7):513-27.
Wenzel R. Health care Reform and the hospital epidemiologist In: Wenzel R, editor. Prevention and Control of Nosocommial Infections. Baltimore: Williams and Wilkins, 1997:47-56.
Navarrete-Navarro S, Rangel-Frausto MS. [Nosocomial infections and quality of health care]. Salud Publica Mex 1999;41 Suppl 1:S64-8.
Rosenthal VD. Device-associated nosocomial infections in limitedresources countries: findings of the International Nosocomial Infection Control Consortium (INICC). Am J Infect Control 2008;36(10):S171 e7-12.