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Nosocomial infections in Lampang Hospital
S Pitaksiripan1, S Butpongsapan, M Tepsuporn
1Pediatrics Service, Lampang Hospital.
Abstract:
A continuous surveillance on N.I. was done in Lampang Hospital from October 1988 to March 1990. The incidence rate of N.I. in 58,355 patients was 3.5 per cent. The average duration of hospital stay was 20.5 days. The highest infection rate was found in intensive care units followed by the surgical and orthopaedic departments (16.8, 5.9, 5.0 per cent) respectively. Urinary tract was the commonest site (19.4 per cent), followed closely by surgical wound, skin and lower respiratory infections. The infection rate was highest in patients aged 25-44 years and the common causative bacteria were Pseudomonas species, Escherichia coli and Klebsiella species. During the study there were two outbreaks of N.I., namely eye infection and diarrhoea. Both were brought under control by simple measures. Excessive use of antimicrobials was also revealed in the study.
Insights
This study monitored nosocomial infections (N.I.) in Lampang Hospital, finding a 3.5% incidence rate. Key findings highlight high infection rates in ICUs and common bacterial causes, emphasizing antimicrobial use concerns.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Clinical Microbiology
Background:
- Nosocomial infections (N.I.) pose a significant threat to patient safety and healthcare costs.
- Continuous surveillance is crucial for understanding infection patterns and implementing control measures.
- Lampang Hospital initiated a surveillance program to assess N.I. incidence and characteristics.
Purpose of the Study:
- To determine the incidence rate of nosocomial infections in a large patient cohort.
- To identify the most affected departments, infection sites, and patient demographics.
- To investigate common causative agents and identify potential areas for antimicrobial stewardship.
Main Methods:
- A prospective surveillance study was conducted over 18 months (October 1988 - March 1990).
- Data collected included patient demographics, infection rates, hospital stay duration, and causative microorganisms.
- Infection sites, departmental rates, and bacterial isolates were systematically recorded.
Main Results:
- The overall incidence rate of N.I. was 3.5% among 58,355 patients, with an average hospital stay of 20.5 days.
- Intensive care units (16.8%), surgical (5.9%), and orthopaedic (5.0%) departments showed the highest infection rates.
- Urinary tract infections (19.4%) were most common, followed by surgical site, skin, and lower respiratory infections. Pseudomonas, E. coli, and Klebsiella were prevalent. Two outbreaks (eye, diarrhea) were managed effectively. Excessive antimicrobial use was noted.
Conclusions:
- Nosocomial infections represent a substantial burden, particularly in critical care and surgical settings.
- Targeted infection control strategies are needed for high-risk departments and common infection sites.
- Prudent antimicrobial use and stewardship are essential to combat rising resistance and improve patient outcomes.