Surveillance for hospital-acquired infections on surgical wards in a Dutch university hospital.
OBJECTIVE
To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections.


METHODS
Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and vascular, thoracic, orthopedic, and general gynecologic and gynecologic-oncologic surgery of the University Medical Center Utrecht, the Netherlands. Data were collected from patients with and without infections, using criteria of the Centers for Disease Control and Prevention.


RESULTS
The infection control team recorded 648 hospital-acquired infections affecting 550 (14%) of 3,845 patients. The incidence density was 17.8 per 1,000 patient-days. Patients with hospital-acquired infections were hospitalized for 19.8 days versus 7.7 days for patients without hospital-acquired infections. Prolongation of stay among patients with hospital-acquired infections may have resulted in 664 fewer admissions due to unavailable beds. Different specialties were associated with different infection rates at different sites, requiring a tailor-made approach. Interventions were recommended for respiratory tract infections in the thoracic surgery ward and for surgical-site infections in the orthopedic and gynecologic surgery wards.


CONCLUSIONS
Surveillance in four surgical wards showed that each had its own prominent infection, risk factors, and indications for specific recommendations. Because prospective surveillance requires extensive resources, we considered a modified approach based on a half-yearly point-prevalence survey of hospital-acquired infections in all wards of our hospital. Such surveillance can be extended with procedure-specific prospective surveillance when indicated.
Kamp-Hopmans
Titia E M
TE
University Medical Center Utrecht, Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Department of Hospital Hygiene & Infection Prevention, HP G04.614, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Blok
Hetty E M
HE
Troelstra
Annet
A
Gigengack-Baars
Ada C M
AC
Weersink
Annemarie J L
AJ
Vandenbroucke-Grauls
Christina M J E
CM
Verhoef
Jan
J
Mascini
Ellen M
EM
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D012308:Risk Management; D018571:Sentinel Surveillance; D013530:Surgical Wound Infection / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000517:prevention & control