Objectives: To conduct a hospital-wide prevalence of infection study to determine relative value of alert organism verses alert condition surveillance in the detection of hospital acquired infection (HAI). Methods: In November 2002 in addition to existing alert organism surveillance (as recommended by the UK Department of Health), the Infection Control Team performed a pan-hospital prevalence study, over 5 days, to capture all patients being treated for bacterial infection. Drug charts were reviewed for all inpatients. The primary inclusion criterion was treatment with antibiotics. Patients receiving antiviral and antifungal agents or antibiotics for prophylaxis were excluded. Cases were followed-up by review of medical notes, interview with the patient's clinical staff members and review of culture results from the Medical Microbiology database, where available. Results: 91.3% of the 945 beds surveyed were occupied. 52% of the patients receiving antibiotics were male and 48% female. 40% of these in-patients were over 65 years old. A total of 396 antibiotics were prescribed for the 261 patients, with 42 (16%) receiving three or more agents. The Critical Care group had the highest percentage of patients on antibiotics (63%) followed by Specialist medicine (51%) and Renal (48%). 185 patients were followed-up. Among these the highest rates of infection were wound followed by respiratory tract infections and bacteraemias. Ten patients had multiple infections. The overall prevalence of infection was 25% and 40% of these were hospital acquired. For the study period, the ratio of patients with 'alert organism' HAI versus non-alert organisms was approximately 1:4. As there were approximately 393 patients with an 'alert organism' HAI in 2002, using the above ratio we estimate there were 1965 patients who had a hospital-acquired infection at Kings during 2002. Conclusion: Current surveillance methodology recommended by the UK Department of Health only detects one quarter of patients being treated for HAI. This highlights the need for increased alert condition surveillance to inform strategy and target resources more appropriately in the management of HAI.
Full conference title:
16th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 16th (2006)