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Infection control in small hospitals. Prevalence surveys in 18 institutions
Abstract:
In prevalance surveys of 18 small hospitals in the intermountain region, 20.4% of the patients had community-acquired infections and 7.2% had infections acquired in the hospital. The types of nosocomial infections and patterns of antibiotic usage were similar to those encountered in large hospitals. In the small hospitals, 49% of the suspected bacterial infection were cultured, whereas at a nearby large hospital 77% were cultured. Seventeen of these small hospitals had an infection-control committee but these committees were unable to assess adequately the extent of their nosocomial infection problems. Monitoring of the environment with bacterial cultures was a frequent practice; overall, a ratio of one environmental culture was performed to each three diagnostic cultures. These results indicate the need to develop and evaluate nosocomial infection control programs in small hospitals.
Insights
Small hospitals face significant community-acquired and hospital-acquired infections, similar to larger facilities. Current infection control practices, including culturing and committees, are insufficient for managing nosocomial infections effectively.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Public Health
Background:
- Community-acquired infections (CAI) and hospital-acquired infections (HAI) are significant concerns in healthcare settings.
- Small hospitals often have different resource constraints and operational structures compared to large hospitals, potentially impacting infection control.
- Understanding the prevalence and patterns of nosocomial infections in small hospitals is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of community-acquired and hospital-acquired infections in small hospitals.
- To compare infection patterns and antibiotic usage in small hospitals with those in large hospitals.
- To evaluate the effectiveness of current infection control practices, including diagnostic culturing and infection-control committees, in small hospitals.
Main Methods:
- Prevalence surveys were conducted across 18 small hospitals in the intermountain region.
- Data on infection types, antibiotic usage, bacterial culturing rates (diagnostic and environmental), and infection-control committee activities were collected.
- Comparison was made with data from a nearby large hospital.
Main Results:
- 20.4% of patients had community-acquired infections, and 7.2% had hospital-acquired infections.
- Nosocomial infection types and antibiotic usage patterns were comparable to large hospitals.
- Diagnostic culturing rates were lower in small hospitals (49%) compared to a large hospital (77%).
- Environmental monitoring was frequent, with a high ratio of environmental to diagnostic cultures.
- Infection-control committees were present but struggled to adequately assess nosocomial infection burdens.
Conclusions:
- Small hospitals experience substantial nosocomial infection rates, necessitating tailored control programs.
- Current infection control practices, particularly diagnostic culturing, are suboptimal in many small hospitals.
- There is a clear need for the development and evaluation of specific nosocomial infection control strategies for small hospital settings.