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Malnutrition is an independent factor associated with nosocomial infections

Published online by Cambridge University Press:  09 March 2007

Stéphane M. Schneider ,
Patricia Veyres ,
Xavier Pivot ,
Anne-Marie Soummer ,
Patrick Jambou ,
Jérôme Filippi ,
Emmanuel van Obberghen  and
Xavier Hébuterne
Stéphane M. Schneider*
Affiliation:
Comité de Liaison Alimentation-Nutrition, CHU de Nice, France
Patricia Veyres
Affiliation:
Comité de Lutte contre l'Infection Nosocomiale, CHU de Nice, France
Xavier Pivot
Affiliation:
Service d'Oncologie, CHU de Besançon, France
Anne-Marie Soummer
Affiliation:
Laboratoire de Biochimie, CHU de Nice, France
Patrick Jambou
Affiliation:
Comité de Lutte contre l'Infection Nosocomiale, CHU de Nice, France
Jérôme Filippi
Affiliation:
Comité de Liaison Alimentation-Nutrition, CHU de Nice, France
Emmanuel van Obberghen
Affiliation:
Laboratoire de Biochimie, CHU de Nice, France
Xavier Hébuterne
Affiliation:
Comité de Liaison Alimentation-Nutrition, CHU de Nice, France
*
*Corresponding author: fax +33 4 92 03 65 75, Email stephane.schneider@unice.fr
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Abstract

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The aim of the present prospective study was to determine if malnutrition, measured using a simple validated score, is an independent risk factor for nosocomial infections (NI) in non-selected hospital in-patients. Between 29 and 31 May 2001, a survey on the prevalence of NI was conducted on all 1637 in-patients (61 (sd 25) years old) in a French university hospital as part of a national survey. Actual and usual body weights were recorded in all in-patients, and serum albumin levels were measured on all blood samples taken during the week before the study. Nutritional status was evaluated by using the nutritional risk index (NRI). Albumin values were obtained in 1084 patients, and complete weight information was obtained in 911. Therefore, NRI was calculated in 630 patients (61 (sd 20) years old): 427 (67·8%) were malnourished. NI prevalence was 8·7%: 4·4% in non-malnourished patients, 7·6% in moderately malnourished patients and 14·6% in severely malnourished patients. In univariate analysis, the odds ratios for NI were 1·46 (95% CI 1·2, 2·1) in moderately malnourished patients and 4·8 (95% CI 4·6, 6·4) in severely malnourished patients. In multivariate analysis, age, immunodeficiency and NRI class influenced NI risk. Vascular and urinary catheters, and surgical intervention, were the extrinsic factors associated with NI, with odds ratios ranging from 2·0 (95% CI 1·8, 2·6) for vascular catheters to 10·8 (95% CI 8·8, 12·6) for association of the three factors. In conclusion, in non-selected hospitalized patients, malnutrition assessed with a simple and objective marker is an independent risk factor for NI. An early screening for malnutrition may therefore be helpful to reduce the high prevalence of NI.

Keywords

Nosocomial infectionsProtein–energy malnutritionSurgical wound infectionHospitalsSurgical wound infectionUrinary catheterizationImmunocompromised host
Type
Research Article
Information
British Journal of Nutrition , Volume 92 , Issue 1 , July 2004 , pp. 105 - 111
Copyright
Copyright © The Nutrition Society 2004

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