Prevalence of nosocomial infections in 15 Italian hospitals: first point prevalance study for the INF-NOS project.
BACKGROUND
The aim of our study was to assess the magnitude of nosocomial infections (NI) in 15 Italian hospitals.


METHODS
A multicenter point prevalence study of NI was carried out in October 2001 among eight medical, surgical and intensive care units in hospitals with more than 400 beds, after a pilot phase performed in April 2001.


RESULTS
Of the 2,165 surveyed patients, 163 had a total of 179 NIs. The global prevalence rate of patients with NI and of NI was respectively 7.5% (95% CI 6.4-8.6) and 8.3% (95% CI 7.1-9.4), ranging from 5.5% (95% CI 4.2-6.8) in medical wards to 34.2% (95% CI 25.7-42.7) in intensive care units (ICUs). The NI prevalence was higher in: hospitals that did not have an infection control committee (ICC) compared to hospitals with an ICC (10.3%, 95% CI 6.4-10.1 versus 7.2, 95% CI 6.0-8.3, p = 0.08); university hospitals compared with non-teaching hospitals (9.4%, 95% CI 4.5-14.2 versus 7.4%, 95% CI 6.3-8.5, p = 0.4) and; hospitals with 1,000 or more beds compared to lower volume hospitals (9.5%, 95% CI 7.3-11.7 versus 6.6%, 95% CI 5.3-7.8, p = 0.02). The most prevalent infections found were lower respiratory tract infections, urinary tract infections and surgical-site infections, representing 38.0%, 20.1% and 12.8%, respectively, of all NI. Among 1,674 patients without any infection, 575 (34.3%) of them had been undergoing antibiotic treatment at the time of the survey.


CONCLUSIONS
The high rate of NI, particularly in ICUs, and the high number of improper procedures emphasize the need to develop clinically-oriented guidelines, tailor active infection control programs and implement an active ICU surveillance system.
Nicastri
E
E
National Institute for Infectious Diseases, Lazzaro Spallanzani, Via Portuense, 292, I-00149 Rome, Italy. nicastri@tiscali.it
Petrosillo
N
N
Martini
L
L
Larosa
M
M
Gesu
G P
GP
Ippolito
G
G
D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D006757:Hospital Units / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control