Nosocomial infections in a rural regional hospital in a developing country: infection rates by site, service, cost, and infection control practices.
OBJECTIVE
To assess the prevalence of nosocomial infections at a rural government hospital from 1992 to 1995.


METHODS
Retrospective review of data from 1992 to 1995 regarding rates of nosocomial infections, cost to government, and infection control practices.


METHODS
653-bed rural hospital providing primary and tertiary care.


METHODS
Patients admitted to the hospital between 1992 and 1995 who were found with hospital-acquired infections during their stay.


METHODS
None.


RESULTS
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.


CONCLUSIONS
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.
Orrett
F A
FA
Faculty of Medical Services, the Department of Pathology and Microbiology, University of the West Indies, St Augustine, Republic of Trinidad and Tobago.
Brooks
P J
PJ
Richardson
E G
EG
D003428:Cross Infection / Q000191:economics / Q000209:etiology* / Q000517:prevention & control*; D003906:Developing Countries; D017721:Hospital Costs; D006748:Hospital Departments; D006779:Hospitals, Public; D006780:Hospitals, Rural; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D014300:Trinidad and Tobago