[Nosocomial infections at a neurologic hospital, analysis of 10 years].
OBJECTIVE
To describe the results of 10 years of nosocomial infection (NI) surveillance at a neurological center and evaluate the impact of control measures.


METHODS
A descriptive and retrospective study was performed at a reference center for adult neurologic and neurosurgical patients located in Mexico City. Between 1990 and 2000, the number, site and type of NI were registered. Chi Square test was employed for statistical analysis of numerical data.


RESULTS
Mean NI rate observed was 21 episodes per 100 discharges, with a 40% reduction during the period. Predominant NI were urinary tract infections (36%), lower respiratory tract infections (31%), phlebitis (9%), primary bacteremia (7%), surgical wound infections (7%), and pneumonia (4%). Control measures with a definite impact were organization of intravenous therapy teams with reduction in bacteremia (p = 0.009). Changes in preoperative care, hair clipping instead of shaving, clorhexidine shampoo, and technique of long tunneled ventriculostomy with a 57% reduction (p = 0.00006) in infections related with neurosurgical procedures. The increase in staff and equipment renewal of the respiratory therapy service decreased respiratory infections.


CONCLUSIONS
The measures that reduced our NI rate may be useful in other centers for neurologic patients.
Soto-Hernández
José Luis
JL
Departamento de Infectología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Insurgentes Sur 3877, Col. La Fama, Delegación Tlalpan, C.P. 14269, México, D.F.
Ramírez-Crescencio
Maria Antonieta
MA
Reyes-Ramírez
Guadalupe
G
Sánchez-Ramos
Araceli
A
Hernández-Velásquez
Malú
M
Angeles Morales
Verónica
V
Amaya-Guerrero
Isabel
I
D003428:Cross Infection / Q000453:epidemiology*; D006801:Humans; D009422:Nervous System Diseases; D012189:Retrospective Studies; D013997:Time Factors