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Septicaemia as a hospital hazard
Abstract:
In 1 year there were 135 episodes of septicaemia in a large referral hospital serving a population of 400,000 people. Of these, 52 were hospital-acquired giving a nosocomial septicaemia rate of 2.08 per 1000 admissions. The mortality rate rose with the number of antibiotics used; from 15% in those receiving one drug to 50% in those receiving three. A wide variety of organisms were encountered, the largest group being Staphylococcus aureus, 12 episodes; and Escherichia coli, nine episodes. Staphylococcus epidermis was pathogenic in seven patients with one death. A review of possible aetiological factors showed that 28 episodes occurred postoperatively with surgery considered directly responsible in 20. Intravenous cannulae were in place in 39 patients at the time of development of infection; they were causal in at least five; with two deaths. Urinary catheters were in situ in 14 patients and causal in at least six, with two deaths. Immunosuppression by drugs carried a worse prognosis than when infection occurred in patients with immunosuppressive disease.
Insights
Hospital-acquired infections (HAIs) and septicaemia pose significant risks, with mortality increasing alongside antibiotic use. Identifying risk factors like surgery and invasive devices is crucial for prevention.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Clinical Microbiology
Background:
- Septicaemia (blood poisoning) is a serious complication in healthcare settings.
- Hospital-acquired infections (HAIs) contribute significantly to patient morbidity and mortality.
- Understanding the epidemiology of septicaemia is vital for effective infection control.
Purpose of the Study:
- To determine the incidence and sources of septicaemia in a large referral hospital.
- To analyze risk factors associated with hospital-acquired septicaemia.
- To evaluate the impact of antibiotic use and patient factors on mortality.
Main Methods:
- Retrospective analysis of 135 septicaemia episodes over one year.
- Calculation of nosocomial septicaemia rates per 1000 admissions.
- Identification of common causative organisms and etiological factors (e.g., surgery, invasive devices).
Main Results:
- A nosocomial septicaemia rate of 2.08 per 1000 admissions was observed.
- Mortality increased with the number of antibiotics used, reaching 50% with three drugs.
- Common pathogens included Staphylococcus aureus and Escherichia coli; postoperative complications and invasive devices (IV cannulae, urinary catheters) were significant risk factors.
Conclusions:
- Hospital-acquired septicaemia is a substantial problem with identifiable risk factors.
- Judicious antibiotic use and careful management of invasive devices are critical.
- Drug-induced immunosuppression worsens prognosis in septicaemia patients.