Monitoring of Intrahospital Infections in the General Hospital Uzice

Background: Intrahospital infections (IHI) are frequent in hospitals all over the world. These infections are recognized as a significant public-health problem.

Objective: Our goal was to establish epidemiological monitoring of the occurrence of IHI at the General Hospital Uzice.

Methods: We retrospectively evaluated IHI in patients treated at General Hospital Uzice between January 2006. to December 2009. Determination of intrahospital infections was done according to criteria defined by the Centers for Disease Control and Prevention from the United States. We reviewed the following aspects regarding IHI: anatomic localization, days of hospitalization, types of bacterial agents and their resistance.

Results: The incidence rate of IHI was 0.6% in 2006, 0.7% in 2007, 1.9% in 2008, and 1.7% in 2009. Rates of surgical site infections were from 2006 to 2009: 48.6%, 54.1%, 29.1%, 22.1%; urinary tract infections: 24.3%, 22.3%, 56.6% and 59.7%; bloodstream infections: 6.7%, 2.3%, 3.7%, 4.1%; respiratory tract infections: 5.4%, 7.1%, 3.7%, 0.4%. The majority of patients with IHI were hospitalized longer than 20 days (average 28.5 days). Staphylococcus aureus accounted for 26%, Escherichia coli for 22%, Klebsiella-Enterobacter for 16.7%, and Pseudomonas spp. for 16.6% of IHI. MRSA rate was 36% while the resistance rates for third generation cephalosporins and carbapenems were 42.5% and 21% in Escherichia coli; 50.3% and 25.2% in Klebsiella-Enterobacter and 59.2% and 33.6% in Pseudomonas spp. respectively.

Conclusions: The incidence rate of IHI is on the rise since 2006. Urinary tract and surgical site are the most frequent anatomic localizations. Staphylococcus aureus and Escherichia coli are the most common causes of IHI.