Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-02T19:15:38.124Z Has data issue: false hasContentIssue false

Assessment of the Value of Repeated Point-Prevalence Surveys for Analyzing the Trend in Nosocomial Infections

Published online by Cambridge University Press:  21 June 2016

Catherine Sartor*
Affiliation:
Comité de Lutte contre les Infections Nosocomiales, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Anne Delchambre
Affiliation:
Comité de Lutte contre les Infections Nosocomiales, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Laurence Pascal
Affiliation:
Département d'Information Médicale, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Michel Drancourt
Affiliation:
Comité de Lutte contre les Infections Nosocomiales, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Philippe De Micco
Affiliation:
Laboratoire de Virologie, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
Roland Sambuc
Affiliation:
Département d'Information Médicale, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Marseille, France
*
Comité de Lutte contre les Infections Nosocomiales, Hôpital de la Conception, 147 bvd Baille, 13385 Marseille cedex 5, France, [email protected]

Abstract

Objective:

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

Setting:

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).

Conclusion:

Adjusted prevalence rates of nosocomial infections showed a significant downward trend during the period of this study.

Type
Orginal Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.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.CrossRefGoogle ScholarPubMed
2.Wenzel, RP, Kaller, MA. Infection control: the premier quality assessment program in United States hospitals. Am J Med 1991;91:27S31S.CrossRefGoogle ScholarPubMed
3.Glenister, HM, Taylor, LJ, Bartlett, CLR, Cooke, EM, Sedgwick, JA, Mackintosh, CA. An evaluation of surveillance methods for detecting infections in hospital inpatients. J Hosp Infect 1993;23:229242.Google Scholar
4.Gaynes, RP, Culver, DH, Emori, TG, et al.The National Nosocomial Infections Surveillance system: plans for the 1990s and beyond. Am J Med 1991;91:116S120S.Google Scholar
5.French Public Hygiene Council. 100 recommendations for survey and prevention of nosocomial infections. Bulletin Epidémiologique Hebdomadaire 1992;11S40S.Google Scholar
6.Vanhems, P, Lepape, A, Savey, A, Jambou, P, Fabry, J. Nosocomial pulmonary infection by antimicrobial-resistant bacteria of patients hospitalized in intensive care units: risk factors and survival. J Hosp Infect 2000;45:98106.CrossRefGoogle ScholarPubMed
7.Vanhems, P, Dumas, AM, Berland, M, et al.Hospital-acquired infections in French maternity units: trends noted in 2-year surveillance (1997-1998). Study Group of Nosocomial Infections in Maternity Units of Southeast France. J Hosp Infect 2000;45:334335.Google Scholar
8.The French Prevalence Survey Study Group. Prevalence of nosocomial infections in France: results of the nationwide survey in 1996. J Hosp Infect 2000;46:186193.Google Scholar
9.Agence Nationale pour l'Accréditation et l'Evaluation en Santé. Manuel d'Accréditation des Établissements de Santé. Paris: Agence Nationale pour l'Accréditation et l'Evaluation en Santé; 1999.Google Scholar
10.Meers, PD, Ayliffe, GAJ, Emmerson, AM, et al.National survey of infection in hospitals. J Hosp Infect 1980;2(suppl):1S51S.CrossRefGoogle Scholar
11.Gastmeier, P, Kampf, G, Wischnewski, N, Schumacher, M, Dashner, F, Ruden, H. Importance of the surveillance method: national prevalence studies on nosocomial infections and the limits of comparison. Infect Control Hosp Epidemiol 1998;19:661667.Google Scholar
12.French, GL, Cheng, AFB, Wong, SL, Donnan, S. Repeated prevalence survey for monitoring effectiveness of hospital infection control. Lancet 1989;2:10211023.Google Scholar
13.Vaque, J, Rossello, J, Arribas, JL. Prevalence of nosocomial infections in Spain: EPINE study 1990-1997. EPINE Working Group. J Hosp Infect 1999;43:105111.CrossRefGoogle ScholarPubMed
14.Weinstein, JW, Mazon, D, Pantelick, E, Reagan-Cirincione, P, Dembry, LM, Hierholzer, WJ. A decade of prevalence surveys in a tertiary care center: trends in infection rates, device utilization and patient acuity. Infect Control Hosp Epidemiol 1999;20:543548.CrossRefGoogle Scholar
15.Christensen, M, Jepsen, OB. Reduced rates of hospital-acquired UTI in medical patients: prevalence surveys indicate effect of active infection control programmes. J Hosp Infect 2001;47:3640.Google Scholar
16.Starakis, I, Marangos, M, Gikas, A, Pediaditis, I, Bassaris, H. Repeated point prevalence survey of nosocomial infections in a Greek university hospital. J Chemother 2002;14:272278.Google Scholar
17.Sartor, C, Sambuc, R, Bimar, MC, Gulian, C, De Micco, P. Prevalence surveys of nosocomial infections using a random sampling method in Marseille hospitals. J Hosp Infect 1995;29:209216.Google Scholar
18.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128140.CrossRefGoogle ScholarPubMed
19.Kahn, HA, Sempos, CT, eds. Statistical Methods in Epidemiology. New York: Oxford University Press; 1989.Google Scholar
20.Burgner, D, Dalton, D, Hanlon, M, Wong, M, Kakakios, A, Isaacs, D. Repeated prevalence surveys of paediatric hospital acquired infection. J Hosp Infect 1996;34:163170.Google Scholar
21.Gikas, APediaditis, I, Roumbelaki, M, et al.Repeated multi-centre prevalence surveys of hospital-acquired infection in Greek hospital. J Hosp Infect 1999;41:1118.Google Scholar
22.Gastmeier, P, Sohr, D, Rath, A, et al.Repeated prevalence investigations on nosocomial infections for continuous surveillance. J Hosp Infect 2000;45:4753.Google Scholar
23.Pittet, D, Harbarth, S, Ruef, C, et al.Prevalence and risk factors for nosocomial infections in four university hospitals in Switzerland. Infect Control Hosp Epidemiol 1999;20:3742.CrossRefGoogle ScholarPubMed
24.Sax, H, Hugonnet, S, Harbarth, S, Herrault, P, Pittet, D. Variation in nosocomial infection prevalence according to patient care setting: a hospital-wide survey. J Hosp Infect 2001;48:2732.CrossRefGoogle ScholarPubMed
25.Signorelli, C, D'Alessandro, D, Collina, D, Fara, GM. Prevalence survey of nosocomial infections in a paediatric hospital. J Hosp Infect 1991;18:139143.Google Scholar
26.Vincent, JL, Bihari, DJ, Suter, PM, et al.The prevalence of nosocomial infection in intensive care units in Europe: results of the European Prevalence of Infection in Intensive Care (EPIC) study. JAMA 1995;274:639644.Google Scholar
27.McLaws, ML, Gold, J, King, K, Irwig, LM, Berry, G. The prevalence of nosocomial and community-acquired infections in Australian hospitals. Med J Aust 1988;149:582590.Google Scholar
28.Haley, RW, Culver, DH, Morgan, WM, White, JW, Emori, TG, Hooton, TM. Increased recognition of infectious diseases in US hospitals through increased use of diagnostic tests, 1970-1976. Am J Epidemiol 1985;121:168181.CrossRefGoogle ScholarPubMed
29.Emori, TG, Edwards, JR, Culver, DH, et al.Accuracy of reporting nosocomial infections in intensive care unit patients to the National Nosocomial Infections Surveillance (NNIS) system: a pilot study. Infect Control Hosp Epidemiol 1998;19:308316.CrossRefGoogle Scholar