Nosocomial Infection Surveillance in Maharat Nakhon Ratchasima Hospital (1994-1997)

Abstract

During a 4 year period from 1994-1997 the nosocomial infection (NI) rate was 2.7-3.6/100 discharged with the highest rate (7.8/100 discharged) in Pediatric ICU. The distibution of NI by site (percentage of total NI) was as follows : lower respiratory tract infection (LRI) 29-45%, bloodstream infection 19-23% and surgical site infection 16-19%. LRI was the most common NI in all ICUs (59-80%). Majority of the causative organisms were gram negative bacilli among which P.aeruginosa, K. pneumoniae and A. baumanii were the three most prevalent while MRSA, the most common gram positive agent, ranked the fifth for the total NI. Five to seven million Baht were spent each year for the cost of NI treatment of which ninety percent were paid for patient in the three major departments : Medicine, Surgery and Pediatrics. Imipenem, ceftazidime, ciprofloxacin and vancomycin were the first four drugs in term of the hospital expenditure. Nosocomial infections are considered as adverse hospital outcomes. NI surveillance helps in problem identifications and intervention plan. Surveillance of NI in cases exposed to invasive devices such as ventilator, urinary catheter and vascular catheter will reflect more precise problems and leads to effective infection control.