Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-28T19:29:49.128Z Has data issue: false hasContentIssue false
  • English
  • Français

Surveys of hospital infection in the Birmingham region: I. Effect of age, sex, length of stay and antibiotic use on nasal carriage of tetracycline-resistant Staphyloccus aureus and on post-operative wound infection

Published online by Cambridge University Press:  15 May 2009

G. A. J. Ayliffe ,
K. M. Brightwell ,
B. J. Collins ,
E. J. L. Lowbury ,
P. C. L. Goonatilake  and
R. A. Etheridge
G. A. J. Ayliffe
Affiliation:
Regional Health Service Infection Research Laboratory, Dudley Road Hospital, Birmingham
K. M. Brightwell
Affiliation:
Regional Health Service Infection Research Laboratory, Dudley Road Hospital, Birmingham
B. J. Collins
Affiliation:
Regional Health Service Infection Research Laboratory, Dudley Road Hospital, Birmingham
E. J. L. Lowbury
Affiliation:
Regional Health Service Infection Research Laboratory, Dudley Road Hospital, Birmingham
P. C. L. Goonatilake
Affiliation:
Department of Production Engineering, University of Aston in Birmingham
R. A. Etheridge
Affiliation:
Department of Production Engineering, University of Aston in Birmingham
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Cross-sectional surveys of infection in relation to ward structure and practice were made in 38 hospitals between 1967 and 1973, including repeat surveys in 12 hospitals. The survey team (a research nurse and a senior microbiologist or technician) visited one ward a day and entered data on patients, including appearance of wounds seen at change of dressings, on the structure of the ward, and on ward practices; bacteriological swabs were taken from noses of all patients and staff of wards visited and from infected or open wounds, also from some environmental sites. Effect of age, sex, length of hospital stay and antibiotic use on carriage of tetracycline-resistant Staphylococcus aureus and on post-operative sepsis are considered here.

Clinical infection (sepsis), further classified as ‘severe’, ‘moderate’ or ‘mild’ in accordance with a code of physical signs, including inflammation and suppuration, was found in 6·1% of clean undrained operation wounds. Drained wounds and those through hollow, heavily colonized viscera (‘contaminated’ wounds) had higher sepsis rates than undrained and ‘clean’ wounds; there was less sepsis with closed drainage and with small drains. Staph. aureus (24%) was the commonest single bacterial species, but gram-negative bacilli (50%) were found in a much larger proportion of septic wounds. The results showed that the infection rate was lowest among patients between 20 and 40 years old. Infection was significantly more common in male than in female patients.

Nasal carriage of tetracycline-resistant Staph. aureus, used as an index of hospital-acquired infection, was commonest in geriatric patients and least common in gynaecological patients. There was correlation between nasal carriage of tetracycline-resistant staphylococci and age of the patient, length of hospital stay, sex, (male greater than female), operative treatment, and treatment with tetracycline, ampicillin and nitrofurantoin, but not with penicillin.

Type
Research Article
Information
Journal of Hygiene , Volume 79 , Issue 2 , October 1977 , pp. 299 - 314
Copyright
Copyright © Cambridge University Press 1977

References

REFERENCES

Ayliffe, G. A. J. (1971). Cross-sectional surveys of infection. In Proceedings of the International Conference on Nosocomial Infections, 1970, p. 282. American Hospital Association, Chicago.Google Scholar
Ayliffe, G. A. J. (1973). Use of antibiotics and resistance. In Current Antibiotic Therapy (ed. Geddes, A. M. & Williams, J. D.), p. 53. Edinburgh and London: Churchill, Livingstone.Google Scholar
Ayliffe, G. A. J., Brightwell, K. M., Collins, B. J. & Lowbury, E. J. L. (1969). Varieties of aseptic practice in hospital wards. Lancet ii, 1117.CrossRefGoogle Scholar
Ayliffe, G. A. J., Collins, B. J., Lowbury, E. J. L. & Wall, Mary (1971). Protective isolation in single rooms in a modified hospital ward. Journal of Hygiene 69, 511.Google Scholar
Barber, M. & Kuper, S. W. A. (1951). Identification of Staphylococcus pyogenes by the phosphatase reaction. Journal of Pathology and Bacteriology 63, 65.CrossRefGoogle ScholarPubMed
Blair, J. B. & Williams, R. B. O. (1961). Phage typing of staphylococci. Bulletin of the World Health Organization 24, 771.Google ScholarPubMed
Brown, V. I. & Lowbury, E. J. L. (1965). Use of an improved cetrimide agar medium and other culture methods for Pseudomonas aeruginosa. Journal of Clinical Pathology 18, 752.CrossRefGoogle ScholarPubMed
Cruse, P. J. B. (1970). Surgical wound sepsis. Canadian Medical Association Journal 102, 251.Google ScholarPubMed
Davidson, A. I. G., Clark, C. & Smith, G. (1971). Post-operative wound infection. A computer analysis. British Journal of Surgery 58, 326, 333.Google Scholar
Eikhoff, T. C., Brackman, P. S., Bennett, J. V. & Brown, J. F. (1969). Surveillance of nosocomial infections in community hospitals. Surveillance methods, effectiveness, and initial results. Journal of Infectious Diseases 120, 305.CrossRefGoogle Scholar
Garner, Julia S., Bennett, J. V., Scheckler, W. E., Maki, G. D. & Brachman, P. S. (1971). Surveillance of nosocomial infections. In Proceedings of the International Conference on Nosocomial Infections, 1970, p. 277. American Hospital Association, Chicago.Google Scholar
Lidwell, O. M. (1961). Sepsis in surgical wounds: multiple regression analysis applied to records of post-operative hospital sepsis. Journal of Hygiene 59, 259.CrossRefGoogle ScholarPubMed
Lidwell, O. M., Davies, J., Payne, R. W., Newman, P. & Williams, R. E. O. (1971). Nasal acquisition of Staphyloccus aureus in partly divided wards. Journal of Hygiene 69, 113.CrossRefGoogle Scholar
Lidwell, O. M., Broch, B., Shooter, R. A., Cooke, B. M. & Thomas, G. B. (1975). Airborne infection in a fully air-conditioned hospital. Journal of Hygiene 75, 445.CrossRefGoogle Scholar
National Research Council (1964). Post-operative wound infections. The influence of ultraviolet irradiation of the operating room and of various other factors. Annals of Surgery 160, Suppl. no. 2.Google Scholar
Public Health Laboratory Service (1960). Incidence of surgical wound infection in England and Wales. Lancet ii, 659.Google Scholar