The preventable proportion of nosocomial infections: an overview of published reports.
The proportion of nosocomial infections potentially preventable under routine working conditions remains unclear. We performed a systematic review to describe multi-modal intervention studies, as well as studies assessing exogenous cross-infection published during the last decade, in order to give a crude estimate of the proportion of potentially preventable nosocomial infections. The evaluation of 30 reports suggests that great potential exists to decrease nosocomial infection rates, from a minimum reduction effect of 10% to a maximum effect of 70%, depending on the setting, study design, baseline infection rates and type of infection. The most important reduction effect was identified for catheter-related bacteraemia, whereas a smaller, but still substantial potential for prevention seems to exist for other types of infections. Based on these estimates, we consider at least 20% of all nosocomial infections as probably preventable, and hope that this overview will stimulate further research on feasible and cost-effective prevention of nosocomial infections for daily practice.
Harbarth
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S
Infection Control Programme, Department of Internal Medicine, University of Geneva Hospitals, 24, rue Micheli-du-Crest, CH-1211, Geneva 14, Switzerland. stephan.harbarth@hcuge.ch
Sax
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H
Gastmeier
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P
D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002408:Catheters, Indwelling / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005240:Feasibility Studies; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D015397:Program Evaluation; D012107:Research Design; D012307:Risk Factors