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. 2005 Sep 1:3:Doc06.

Surveillance of nosocomial infections at a Saudi Arabian military hospital for a one-year period

Moataz M Abdel-Fattah  1
Affiliations

Surveillance of nosocomial infections at a Saudi Arabian military hospital for a one-year period

Moataz M Abdel-Fattah. Ger Med Sci. .

Abstract
in English, German

The objectives of the current study are to define how many and what kind of nosocomial infections are occurring, what are the causative microbes and what kind of drugs can be used in treatment of infection at Al-Hada Armed Forces Hospital, Taif, Saudi Arabia during the year 2004. A prospective study was implemented for all cases admitted at Al-Hada Armed Forces Hospital during the period 1(st) January, 2004 till 31(st) December, 2004 and which developed infection. Determination of nosocomial infections was performed using standardized CDC criteria. A total of 1382 patients had developed infection during hospital admission and were included in the study. Of them, 668 (48.3%) had nosocomial infection and 714 (51.7%) had community-acquired infection. Among those who developed nosocomial infections, 216 (32.3%), 172 (25.7%) and 124 (18.6%) had respiratory tract (RTI), urinary tract (UTI) and blood stream infections (BSI) respectively. Surgical site infection (SSI) was reported in 86 cases (12.9%). The overall nosocomial infection rate along the study period was 4.98 per 100 discharged patients. Gram-positive organisms were reported in 31.8%. MRSA (Methicillin-resistant S. aureus) was the commonest (10.2%), followed by coagulase negative staphylococci (8.5%) and MSSA (Methicillin-susceptible S. aureus, 7.4%). While Gram-negative organisms were reported in 66.2%, E. coli was the commonest (22.3%), followed by Pseudomonas aeruginosa (17.6%) and Klebsiella pneumoniae (9.9%). Acinetobacter spp. and MRSA were highly sensitive to Imipenem (88.6%) and Vancomycin (98.5%) respectively. E. coli were highly sensitive to most of the antimicrobial agents except ampicillin (26.6%).

Conclusions: Pneumonia, urinary tract infections, and blood stream infections made up the great majority of nosocomial infections. There is a need for further risk assessment associated with main types of infection.

Die vorliegende Studie hatte zum Ziel, im Al-Hada Armed Forces Hospital (Taif, Saudi Arabien) über den Zeitraum eines Jahres (2004) hinweg die Zahl und die Art der nosokomialen Infektionen zu erfassen, die Erreger zu bestimmen und zu beschreiben, welche Antibiotika zur Behandlung der Infektionen benutzt werden können.

In einer prospektiven Studie wurden alle Fälle erfasst, bei denen die in das Al-Hada Armed Forces Hospital im Jahre 2004 (1. Januar 2004 bis 31. Dezember 2004) eingewiesenen Patienten eine Infektion entwickelten. Die Klassifizierung als nosokomiale Infektion wurde nach den standardisierten Kriterien der CDC durchgeführt. Insgesamt haben 1382 Patienten Infektionen während des Hospitalaufenthaltes entwickelt und wurden in die Studie einbezogen. Von diesen hatten 668 (48,3%) nosokomiale Infektionen und 714 (51,7%) erworbene Infektionen. Unter den Patienten mit nosokomialen Infektionen hatten 216 (32,3%) Infektionen der oberen Atemwege, 172 (25,7%) Harnwegsinfektionen und 124 (18,6%) eine Bakterieämie (Sepsis). Im chirurgischen Bereich wurden 86 Fälle (12,9%) von Infektionen beobachtet. Die gesamte nosokomiale Infektionsrate lag während der Studiendauer bei 4,98 pro 100 entlassenen Patienten. Grampositive Bakterien wurden in 31,8% der Fälle gefunden. MRSA war am häufigsten (10,2%), gefolgt von koagulase-negativen Staphylokokken (8,5%) und MSSA (7,4%). Gramnegative Bakterien wurden in 60,2% der Fälle berichtet. E-Coli war der am häufigsten gefundene Keim (22,3%), gefolgt vom Pseudomonas aeruginosa (17,6%) und Klepsiellapneumonie (9,9%). Acinetobacter spp. und MRSA waren hoch sensitiv für Imipenem (88,6%) und Vancomycin (98,5%). E-Coli waren hochsensitiv für die meisten antimikrobiellen Substanzen, ausgenommen Ampicillin (26,6%).

Schlussfolgerung: Pneumonien, Harnwegsinfektionen und Bakterieämien machten den größten Teil der nosokomialen Infektionen aus. Die Bewertung des Risikos, das mit den Haupttypen der nosokomialen Infektionen verbunden ist, sollte noch genauer erfolgen.

Keywords: Saudi Arabia; antibiotic; microorganisms; nosocomial infections; sensitivity; surveillance.

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Figures

Table 1
Table 1. Distribution of the study population according to age, sex, and type of infection (Al-Hada Armed Forces Hospital 2004)
Table 2
Table 2. Distribution of the study population according to ward and type of infection (Al-Hada Armed Forces Hospital 2004)
Table 3
Table 3. Distribution of infection cases by time and type of infection (Al-Hada Armed Forces Hospital 2004)
Table 4
Table 4. Organism isolates (n=1438) identified from 1382 patients
Table 5
Table 5. Distribution of commonly reported organisms by site of nosocomial infection
Table 6
Table 6. Antibiotic sensitivity of Gram-positive isolates
Table 7
Table 7. Antibiotic sensitivity of Gram-negative isolates
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