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High Level of Gastrointestinal Nosocomial Infections in the German Surveillance System, 2002–2008

Published online by Cambridge University Press:  02 January 2015

Michaela Spackova ,
Doris Altmann ,
Tim Eckmanns ,
Judith Koch  and
Gerard Krause
Michaela Spackova*
Affiliation:
European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Stockholm, Sweden Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
Doris Altmann
Affiliation:
Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
Tim Eckmanns
Affiliation:
Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
Judith Koch
Affiliation:
Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
Gerard Krause
Affiliation:
Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
*
Robert Koch Institute, Department of Infectious Disease Epidemiology, DGZ Ring 1, 13086 Berlin, Germany, (spackova.michaela@gmail.com)
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Abstract

Objective.

Surveillance of nosocomial infections (NIs) is well established in many countries but often does not include gastrointestinal infections. We sought to determine the proportion of NIs among all hospitalized cases for the 4 most prevalent types of gastrointestinal infections in Germany.

Methods.

We analyzed all notifications of laboratory-confirmed or epidemiologically linked gastrointestinal infections due to norovirus, rotavirus, Salmonella species, and Campylobacter species reported to the Robert Koch Institute in Berlin, Germany, from 2002 through 2008. Infections were considered nosocomial if disease onset was more than 2 days after hospitalization for norovirus, rotavirus, and Salmonella infection and more than 5 days after hospitalization for Campylobacter infection.

Results.

During the study period, 710,725 norovirus, 394,500 rotavirus, 395,736 Salmonella, and 405,234 Campylobacter gastrointestinal infections were reported. Excluding cases for which nosocomial status could not be determined, we identified 39,424 (49%) of 80,650 norovirus, 11,592 (14%) of 83,451 rotavirus, 3,432 (8%) of 43,348 Salmonella, and 645 (2%) of 33,503 Campylobacter gastrointestinal infections as definite nosocomial cases. Multivariate analysis confirmed higher risk of gastrointestinal NIs for patients aged more than 70 years (relative risk [RR], 7.0 [95% confidence interval {CI}, 6.7–7.2]; P < .001) and residents of western states (RR, 1.3 [95% CI, 1.2–1.3]; P < .001) and lower risk for female patients (RR, 0.9 [95% CI, 0.9–0.9; P < .001). Yearly NI proportions remained stable except for norovirus.

Conclusions.

The investigated gastrointestinal NIs in Germany do not show a clear trend, but they are at high level, revealing potential for public health action and improvement of hospital infection control mainly among older patients. National prevalence studies on gastrointestinal NIs would be of additional value to give more insight on how and where to improve hospital infection control.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 12 , December 2010 , pp. 1273 - 1278
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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