[Outbreaks of health-care-associated infections in the province of Vojvodina].
BACKGROUND
The goal is to investigate epidemiological characteristics of outbreaks of health-care-associated infections in health care institutions such as hospitals, nursing homes and ambulatory care settings.


METHODS
Relevant data associated with outbreaks in health-care settings in the period from 1980 to 2004 were retrospectively collected from epidemiological annual reports of infectious diseases in Vojvodina. Descriptive statistics were applied to the data.


RESULTS
The mean number of outbreaks is 7 per year (ranging from 0 to 13 outbreaks) involving 22 cases per outbreak (ranging from 2 to 74 cases). The most frequently involved settings (51%) were nursing homes and most (31%) of the patients were more than 60 years old. This surveillance documented that wards for children less than 12 months of age were the most frequently (57.5%) associated with nosocomial outbreaks in hospitals. The leading diseases were gastrointestinal tract infections with case fatality rate of 1.8%, that is 10-100 fold higher than rates in general population. The leading transmission route in 70% of outbreaks was contact, demonstrating the association between infections and poor general and hand-hygiene policies.


CONCLUSIONS
The proportion of nosocomial outbreaks in total number of outbreaks is 9%. The most frequent are gastrointestinal outbreaks transmitted in long-term-care facilities by contact route, involving elderly patients. Introducing proper environmental and hand hygiene policies in health-care settings with strict implementation of procedures may significantly decrease the number of nosocomial infections and prevent nosocomial outbreaks.
Cosić
Gorana
G
Sektor za epidemiologiju, Centar za kontrolu i prevenciju bolesti, Institut za zastitu zdravlja Novi Sad . nsepid@eunet.yu
Stefanović
Slavica
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000635:transmission; D004196:Disease Outbreaks; D006801:Humans; D007223:Infant; D008875:Middle Aged; D015022:Yugoslavia / Q000453:epidemiology