Long term trends in the occurrence of nosocomial blood stream infection
Hospital care has long been associated with development of nosocomial infection. Recently, these infections have been identified as a significant public health problem. Changes in health care delivery over time, including the increased use of invasive procedures or immunosuppressive therapy in hospitalized patients and, conversely, out of hospital treatment of less seriously ill patients has likely changed the frequency and pattern of nosocomial infections. However, it has been difficult to document trends in the occurrence of all nosocomial infections, given the difficulty of capturing such data and the limited immediate benefit of doing so. Noso- comial infections associated with blood stream infection account for less than 10% of the total, but may result in greater attributable mortality, prolonged length of hospitalization and a higher cost of care than other infections. Furthermore, such infections are much easier to detect in a prospective surveillance system. Changes in the occurrence of noso- comial blood stream infections may, therefore, provide easily obtainable data which can be used as a surrogate for changes in all nosocomial infections.
Since August 1986, blood culture reports have been pro- spectively monitored at University of Alberta Hospital to determine the occurrence of nosocomial bloodstream infection. Studies of organ system infections resulting in bloodstream infection and specific microorganisms causing those infections have been reported. The present study examines all sources, microbiological etiology and long term trends in the frequency of nosocomial bloodstream infection from August 1, 1986 to December 31, 1996.
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