The Second National Prevalence Survey of Infection in Hospitals—overview of the results

doi:10.1016/S0195-6701(96)90144-9

Journal of Hospital Infection

Volume 32, Issue 3, March 1996, Pages 175-190

https://doi.org/10.1016/S0195-6701(96)90144-9 Get rights and content

Abstract

This study was designed to assess the overall prevalence of infection among patients in hospitals in the UK and the Republic of Ireland. Patient data were collected and entered directly into a portable Olivetti (A12 notebook) computer with a custom-designed program (Epi-Info version 5.01). The statistical analysis was performed using the Statistical Package for Social Sciences software (SPSS). In all, 37 111 patients from 157 centres were studied, and a mean hospital acquired infection (HAI) prevalence rate of 9·0% (range 2–29%) was calculated. HAI rates were higher in teaching hospitals (11·2%) than in non-teaching hospitals (8·4%) P < 0·001. Four major sites of infections—infections of the urinary tract (23·2%), surgical-wound infections (10·7%), lower-respiratory tract (22·9%) and skin infections (9·6%)—accounted for 66·5% (2559 of 3848) of the total infections identified.

References (16)

AM Emmerson et al.
The second National prevalence survey of infection in hospitals: methodology
J Hosp Infect
(1995)
DJ Byrne et al.
Wound infection rates: the importance of definition and post-discharge wound surveillance
J Hosp Infect
(1994)
RP Wenzel et al.
Surveillance and use of computers in hospital infection control
J Hosp Infect
(1989)
GL French et al.
Repeated prevalence surveys for monitoring effectiveness of infection control
Lancet
(1989)
Report of a steering group. National prevalence survey of hospital-acquired infections: definitions
J Hosp Infect
(1993)
PD Meers et al.
Report on the National Survey of Infection in Hospitals 1980
J Hosp Infect
(1981)
Department of Health
Hospital Infection Control; guidance on the control of infection in hospitals. Prepared by the Hospital Infection Working Group of the Department of Health and Public Health Laboratory Service
BAPS
(1995)
P Aavitsland et al.
Hospital-acquired infections in Norway. A national prevalence survey in 1991
Second J Infect Dis
(1992)

There are more references available in the full text version of this article.

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Point prevalence surveys are an important surveillance method for determining the burden of healthcare-associated infections (HCAIs).
To outline the key results of two point prevalence surveys in England (2011 and 2016).
All National Health Service and independent sector hospitals in England were eligible to participate. Data were collected between September and November in both 2011 and 2016 based on the protocol and codebook devised by the European Centre for Disease Prevention and Control. Analysis was performed using Stata Version 13 and SAS Version 9.3. A mixed-effects model was applied, which allowed estimation of organization-specific means and accounted for the heterogeneity in the responses from different organizations.
A total of 100,755 case records were included (52,433 in 2011 and 48,312 in 2016). The estimated prevalence of HCAIs was slightly higher in 2016 [6.89%, 95% confidence interval (CI) 6.21–7.57%] than in 2011 (6.41%, 95% CI 5.75–7.06%). In both surveys, the prevalence of HCAIs was highest in adult intensive care units (23.1% in 2011, 21.2% in 2016), and pneumonia/lower respiratory tract infections was the most common cause of HCAIs (22.7% in 2011 vs 29.2% in 2016). Inpatients in acute hospitals were older and had higher risk of dying in 2016 compared with 2011; however, the proportion of inpatients with HCAIs or on antibiotics did not differ significantly.
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The aim of this study was to describe the patterns of antimicrobial resistance (AMR) of bacterial isolates causing hospital-acquired infections (HAIs) in the intensive care unit (ICU) of a tertiary hospital in Kazakhstan.
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During the study period, 546 patients were admitted to the ICU, of whom 135 (24.7%) developed at least one HAI. Most HAIs caused by Gram-positive bacteria were due to Enterococcus faecalis, which were resistant to aminoglycosides in >70% cases. Gram-negative bacteria were isolated in ca. 50% of cases, thus representing the greatest burden of HAIs. Very high resistance rates to ceftriaxone, cefotaxime and cefuroxime were observed. Moreover, Pseudomonas aeruginosa and Acinetobacter baumannii were resistant to carbapenems in <20% and in ca. 45% of cases, respectively.
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Given the importance of monitoring healthcare-associated infections (HCAIs) and the consumption of antibiotics, a regional point prevalence survey was conducted in Liguria between March and April 2016.
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Data on risk factors and use of antibiotics were collected for each hospitalized patient. To define the variables significantly associated with HCAI, univariate and multivariate analyses were conducted. Standardized infection ratio and standardized antimicrobial use ratio were measured for each participating hospital.
A total of 3647 patients were enrolled. In all, 429 HCAIs were diagnosed in 376 patients, giving a prevalence of HCAI of 10.3%. Respiratory tract (21.7%) and urinary tract (20%) were the most frequent sites of infection. High rates of meticillin-resistant Staphylococcus aureus (47.4%) and Enterobacteriaceae resistant to carbapenems (26.3%) were isolated. Forty-six percent of patients received at least one antibiotic. Combinations of penicillins including β-lactamase inhibitors (24.1%) were the most widely used; the main indication (46.7%) was the treatment of a community-acquired infection.
There was an increase in HCAI prevalence compared to a similar survey conducted in 2007; however, the performance of overlapping investigations will enable more reliable considerations. Nevertheless, data on antimicrobial resistance and use of antibiotics are consistent with the national trend. Despite methodological limitations, prevalence studies are useful to monitor HCAI over time and encourage greater awareness of the problem by all stakeholders.
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To assess Asian data from Global Prevalence Study on Infections in Urology (GPIU study) which has been performed more than 10 years.
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Uropathogens in many Asian countries had high resistance to broad-spectrum antibiotics. Knowledge of regional and local resistance data and prudent use of antibiotics are important for proper management of UTI in Asian countries.
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Evaluate the patient safety incidents that occur in the emergency departments of our region.
Observational study conducted in all the hospital emergency departments in the Regional Health Service of Murcia. After systematic random sampling, data were collected during care and a week later by telephone survey. Health professionals of each service were trained and collected the information, following the methodology of the National Study of Adverse Events Related to Hospitalization –ENEAS– and the Adverse Events Related to Spanish Hospital Emergency Department Care –EVADUR–.
A total of 393 samples were collected, proportional to the cases treated in each hospital. In 10 cases (3.1%) the complaint was a previous safety incident. At least one incident was detected in 47 patients (11.95%; 8.7 to 15.1%). In 3 cases there were 2 incidents, bringing the number of incidents to 50. Regarding the impact, the 51% of incidents caused harm to the patients. The effects more frequent in patients were the need for repeat visits (9 cases), and mismanagement of pain (8 cases). In 24 cases (51.1%) health care was not affected, although 3 cases required an additional test, 11 cases required further consultation, and led to hospitalisation in 2 cases. The most frequent causal factors of these incidents were medication (14) and care (12). The incidents were considered preventable in 60% of cases.
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^☆: This work was funded by the Hospital Infection Society and a research grant awarded to Professor A. M. Emmerson, on behalf of the Hospital Infection Society, from The Nuffield Provincial Hospitals Trust.

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Original articleThe Second National Prevalence Survey of Infection in Hospitals—overview of the results☆

Abstract

J Hosp Infect

J Hosp Infect

J Hosp Infect

Lancet

Report of a steering group. National prevalence survey of hospital-acquired infections: definitions

J Hosp Infect

Report on the National Survey of Infection in Hospitals 1980

J Hosp Infect

Hospital Infection Control; guidance on the control of infection in hospitals. Prepared by the Hospital Infection Working Group of the Department of Health and Public Health Laboratory Service

BAPS

Hospital-acquired infections in Norway. A national prevalence survey in 1991

Second J Infect Dis

Original article
The Second National Prevalence Survey of Infection in Hospitals—overview of the results☆