Periodic surveillance of nosocomial infections in a neurosurgery intensive care unit.
BACKGROUND
We assessed data on the epidemiology of nosocomial infections (NIs) in a 14-bed neurosurgical intensive care unit (NSICU) and used surveillance data for the promotion of quality improvement activities.


METHODS
Prospective periodic surveillance was performed over five 3-month periods between July 1998 and October 2002 on all patients admitted with a length of stay > 24 hours.


RESULTS
763 patients with a total of 4,512 patient days and a mean length of stay of 5.9 days were enrolled within the 15-month study period. A total of 93 NIs were identified in 82 patients. Urinary tract infections (24.7%), pneumonia (23.6%), and bloodstream infections (17.2%) were the most frequent NIs recorded. Device-associated incidence rates were 6.0 (3.8-9.0, CI(95%)) for urinary tract infection, 4.4 (2.4-7.4, CI(95%)) for bloodstream infection, and 10.3 (6.3-15.9, CI(95%)) for pneumonia per 1,000 days at risk. For improvement of infection control-related processes, evidence-based infection control guidelines were established and an NSICU nurse was designated to be responsible for infection control issues on the ward. In addition, several infection control problems arose during the observation periods and were rapidly responded to by introducing specific intervention strategies.


CONCLUSIONS
Periodic surveillance is a valuable tool for assessing the epidemiology of NIs in the NSICU setting as well as for promoting the initiation of quality improvement activities.
Zolldann
D
D
Dept. of Infection Control, Aachen University Hospital, 52074 Aachen, Germany. dzolldann@gmx.de
Thiex
R
R
Häfner
H
H
Waitschies
B
B
Lütticken
R
R
Lemmen
S W
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011159:Population Surveillance; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012307:Risk Factors