Skip to main content
×
×
Home

Nosocomial Infection Surveillance in a Surgical Intensive Care Unit in Spain, 1996-2000: A Time-Trend Analysis

  • Máxima Lizán-Garcia (a1), Ramón Peyro (a2), Manuel Cortiña (a1) (a2), María Dolores Crespo (a3) and Aurelio Tobias (a4) (a5)...
Abstract
Objective.

To establish the occurrence, distribution, and secular time trend of nosocomial infections (NIs) in a surgical intensive care unit (ICU).

Design and Setting.

Follow-up study in a teaching hospital in Spain.

Methods.

In May 1995 we established an nosocomial infection surveillance system in our surgical ICU. We collected information daily for all patients who were in the ICU for at least 48 hours (546 patients from 1996 through 2000). We used the Centers for Disease Control and Prevention definitions and criteria for infections. Monthly, we determined the site-specific incidence densities of NIs, the rates of medical device use, and the Poisson probability distribution, which determined whether the case count equalled the number of expected cases (the mean number of cases during the previous year, with extreme values excluded). We compared yearly and monthly infection rates by Poisson regression, using site-specific NIs as a dependent variable and year and month as dummy variables. We tested annual trends with an alternative Poisson regression model fitting a single linear trend.

Results.

The average rate of catheter-associated urinary tract infections was 8.4 per 1000 catheter-days; that of ventilator-associated pneumonia, 21 per 1000 ventilator-days; and that of central line–associated bloodstream infections, 30 per 1000 central line–days. The rate of urinary tract infections did not change over the study period, but there was a trend toward decreases in the rates of central line–associated bloodstream infections and ventilator-associated pneumonia.

Conclusion.

An NI surveillance and control program contributed to a progressive decrease in NI rates.

Copyright
Corresponding author
Servicio Medicina Preventiva/Hospital General, C/ Hermanos Falco 3, 2001 Albacete, Spain (mxlizan@telefonica.net)
References
Hide All
1.Fridkin, SK, Welbel, SF, Weinstein, RA. Magnitude and prevention of nosocomial infections in the intensive care unit. Infect Dis Clin North Am 1997; 11:479496.
2.Pallavicini, F, Pennisi, MA, Izzi, I, et al. Nosocomial infection rates in an Italian intensive care unit using the national nosocomial infection surveillance system. Infect Control Hosp Epidemiol 2001; 22:132133.
3.Fernandez-Crehuet, R, Diaz-Molina, C, de Irala, J, Martinez-Concha, D, Salcedo-Leal, I, Masa-Calles, J. Nosocomial infection in an intensive-care unit: identification of risk factors. Infect Control Hosp Epidemiol 1997; 18:825830.
4.Grupo de Trabajo de Enfermedades Infecciosas de la Sociedad Española de Medicina Intensiva Critica y Unidades Coronarias. Estudio Nacional de Vigilancia e Infección Nosocomial en Servicios de Medicina Intensiva. Informe 2000.
5.National Nosocomial Infection Surveillance (NNIS) System Report, Data Summary from January 1992-June 2001, issued August 2001. Am J Infect Control 2001;29:404421.
6.Venberghe, A, Laterre, P, Goenen, M, et al. Surveillance of hospital-acquired infection in an intensive care department-the benefit of the full-time presence of an infection control nurse. J Hosp Infect 2002;52:5659.
7.Jamulitrat, S, Narong, MN, Thongpiyapoom, S. Trauma severity scoring systems as predictors of nosocomial infection. Infect Control Hosp Epidemiol 2002; 23:268273.
8.Urli, T, Perone, G, Acquarolo, A, Zappa, S, Antonini, B, Ciani, A. Surveillance of infections acquired in intensive care: usefulness in clinical practice. J Hosp Infect 2002; 52:130135.
9.Jarvis, WR, Edwards, JR, Culver, DH, et al. Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Am J Med 1991; 91(3B): 185S191S.
10.Centers for Disease Control and Prevention. Updated Guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR 2001; 50(RR-13):135.
11.Pottinger, JM, Herwaldt, L, Peri, TM. Basics of surveillance: an overview. In: Herwaldt, LA, Decker, MD / The Society for Healthcare Epidemiology of America, ed. A Practical Handbook for Hospital Epidemiologists. Thorofare, NJ: Slack; 1998.
12.Decker, MD, Sprouse, MW. Hospitalwide Surveillance Activities, 158-192. In: Wenzel, RP, ed. Assessing Quality Health Care. Perspectives for Clinicians. Baltimore, MD: Williams & Wilkins, 1992:158192.
13.Ely, JW, Dawson, JD, Lemke, JH, Rosenberg, J. An introduction to time-trend analysis. Infect Control Hosp Epidemiol 1997; 18:267274.
14.Perez-Hoyos, S, Ballester, F, Tenias, JM. Uso de la regresión de Poisson para la detección de casos en series temporales de enfermedades de declaración obligatoria con pocos casos semanales. Gac Sanit 1999; 13(Suppl 2):3368.
15.Beck-Sague, C, Jarvis, WR, Martone, WJ. Outbreak investigations. Infect Control Hosp Epidemiol 1997; 18:138145.
16.Frome, EL. The analysis of rates using Poisson regression models. Biometrics 1983; 39:665674.
17.Delgado-Rodriguez, M, Gomez-Ortega, A, Sillero-Arenas, M, Martinez-Gallego, G, Medina-Cuadros, M, Llorca, J. Efficacy of surveillance in nosocomial infection control in a surgical service. Am J Infect Control 2001; 29:289294.
18.Frome, EL, Checkoway, H. Epidemiologic programs for computers and calculators. Use of Poisson regression models in estimating incidence rates and ratios. Am J Epidemiol 1985; 121:309323.
19.Merino, JM, Moreno, E, Padilla, M, Rodríguez-Miñon, P, Villarino, A. Distribuciones discretas de probabilidad 566-569, EN: Análisis de datos en Psicología I UNE, Madrid 2001.
20.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985; 121:182205.
21.Fridkin, SK, Pear, SM, Williamson, TH, Galgiani, JN, Jarvis, WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996; 17:150158.
22.Robert, J, Fridkin, SK, Blumberg, HM, et al. The influence of the composition of the nursing staff on primary bloodstream infection rates in a surgical intensive care unit. Infect Control Hosp Epidemiol 2000; 21:1217.
23.Alonso-Echanove, J, Edwards, JR, Richards, MJ, et al. Effect of nurse staffing and antimicrobial-impregnated central venous catheters on the risk for bloodstream infections in intensive care unit. Infect Control Hosp Epidemiol 2003; 24:916925.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Abstract views

Total abstract views: 86 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 17th August 2018. This data will be updated every 24 hours.