[The estimation of the cost of nosocomial infection in an intensive care unit].
ABSTRACT Nosocomial infection (NI) represents an increase of hospital morbidity and mortality. The data available concerning the hospital expenses due to the prolongation of hospital stay associated to NI are fundamentally derived from American studies. The aim of this study was to evaluate the direct cost of nosocomial infection in an intensive medicine unit (IMU).
A study of cases and paired controls was carried out with a cohort study made up of 88 cases and 88 controls paired by age and severity (APACHE II grading). Previously identified confusion factors were controlled in the analysis.
The mean stay in the IMU for infected patients was 17.2 days and for non infected patients 6.8 days. When these stays were adjusted by the variables associated with both NI and in the IMU this became 14.2 days for infected patients and 9.9 days for uninfected patients. The prolongation of stay in the IMU due to NI was 4.3 days. The extra cost for the hospital due to infection acquired by a patient's during stay in the IMU was estimated as 239,441 pesetas.
The methodology used was considered as valid for estimating the prolongation of stay in intensive medicine units attributed to nosocomial infection. The high economic expense which nosocomial infection represents emphasizes the justification for measures of control of this entity.
Article: Retrospective analysis of nosocomial infections in the intensive care unit of a tertiary hospital in China during 2003 and 2007.[show abstract] [hide abstract]
ABSTRACT: Nosocomial infections are a major threat to patients in the intensive care unit (ICU). Limited data exist on the epidemiology of ICU-acquired infections in China. This retrospective study was carried out to determine the current status of nosocomial infection in China. A retrospective review of nosocomial infections in the ICU of a tertiary hospital in East China between 2003 and 2007 was performed. Nosocomial infections were defined according to the definitions of Centers for Disease Control and Prevention. The overall patient nosocomial infection rate, the incidence density rate of nosocomial infections, the excess length of stay, and distribution of nosocomial infection sites were determined. Then, pathogen and antimicrobial susceptibility profiles were further investigated. Among 1980 patients admitted over the period of time, the overall patient nosocomial infection rate was 26.8% or 51.0 per 1000 patient days., Lower respiratory tract infections (LRTI) accounted for most of the infections (68.4%), followed by urinary tract infections (UTI, 15.9%), bloodstream (BSI, 5.9%), and gastrointestinal tract (GI, 2.5%) infections. There was no significant change in LRTI, UTI and BSI infection rates during the 5 years. However, GI rate was significantly decreased from 5.5% in 2003 to 0.4% in 2007. In addition, A. baumannii, C. albicans and S. epidermidis were the most frequent pathogens isolated in patients with LRTIs, UTIs and BSIs, respectively. The rates of isolates resistant to commonly used antibiotics ranged from 24.0% to 93.1%. There was a high and relatively stable rate of nosocomial infections in the ICU of a tertiary hospital in China through year 2003-2007, with some differences in the distribution of the infection sites, and pathogen and antibiotic susceptibility profiles from those reported from the Western countries. Guidelines for surveillance and prevention of nosocomial infections must be implemented in order to reduce the rate.BMC Infectious Diseases 02/2009; 9:115. · 3.12 Impact Factor