Assessment of the value of repeated point-prevalence surveys for analyzing the trend in nosocomial infections.
OBJECTIVE
To assess the value of repeated point-prevalence surveys in measuring the trend in nosocomial infections after adjustment for case mix.


METHODS
A 3,500-bed teaching facility composed of 4 acute care hospitals.


METHODS
From May 1992 to June 1996, eight point-prevalence surveys of nosocomial infections were performed in the hospitals using a sampling process. The trend of adjusted nosocomial infection rates was studied for the four surveys that collected data on indwelling catheters. Adjusted rates were calculated using a logistic regression model and a direct standardization method.


RESULTS
From 1992 to 1996, a total of 20,238 patients were included in the 8 point-prevalence surveys. The nosocomial infection rate decreased from 8.6% in 1992 to 5% in 1996 (P < .001). The analysis of adjusted nosocomial infection rates included 9,600 patients. Four independent risk factors were identified: length of stay greater than 12 days, hospitalization in an intensive care unit, presence of an indwelling urinary catheter, and history of a surgical procedure. After adjustment for case mix, the nosocomial infection rate still showed a downward trend (from 7.2% in 1993 to 5.1% in 1996; P = .02).


CONCLUSIONS
Adjusted prevalence rates of nosocomial infections showed a significant downward trend during the period of this study.
Sartor
Catherine
C
Comité de Lutte contre les Infections Nosocomiales, Hôpital de la Conception, 147 bvd Baille, 13385 Marseille cedex 5, France. catherine.sartor@ap-hm.fr
Delchambre
Anne
A
Pascal
Laurence
L
Drancourt
Michel
M
De Micco
Philippe
P
Sambuc
Roland
R
D000368:Aged; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data / Q000639:trends; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors; D014546:Urinary Catheterization / Q000009:adverse effects