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The Prevalence and Estimates of the Cumulative Incidence of Hospital-Acquired Infections Among Patients Admitted to Auckland District Health Board Hospitals in New Zealand

Published online by Cambridge University Press:  02 January 2015

Nicholas Graves*
Affiliation:
Centre for Health Care Related Infection Surveillance and Prevention, Princess Alexandra Hospital, and the School of Public Health, Queensland University of Technology, Queensland, Australia
Tanya M. Nicholls
Affiliation:
Auckland District Health Board, Auckland, New Zealand
Christopher G. S. Wong
Affiliation:
Middlemore Hospital Auckland, Auckland, New Zealand
Arthur J. Morris
Affiliation:
Auckland District Health Board, Infection Control Service, Auckland, New Zealand
*
School of Public Health, QUT, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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Abstract

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Objectives:

To report the pooled results of seven prevalence surveys of hospital-acquired infections conducted between November 1996 and November 1999, and to use the data to predict the cumulative incidence of hospital-acquired infections in the same patient group.

Design:

The summary and modeling of data gathered from the routine surveillance of the point prevalence of hospital-acquired infections.

Setting:

Auckland District Health Board Hospitals (Auckland DHBH), the largest publicly funded hospital group in New Zealand supplying secondary and tertiary services.

Patients:

All inpatients.

Method:

Point-prevalence surveys were conducted including all patients in Auckland DHBH. Standard definitions of hospital-acquired infection were used. The data from the seven surveys were pooled and used in a modeling exercise to predict the cumulative incidence of hospital-acquired infection. An existing method for the conversion of prevalence to cumulative incidence was applied. Results are presented for all patients and stratified by clinical service and site of hospital-acquired infection.

Results:

The underlying patterns of hospital-acquired infection by site and service were stable during the seven time periods. The prevalence rate for all patients was 9.5%, with 553 patients identified with one or more hospital-acquired infections from a population of 5,819. The predicted cumulative incidence for all patients was 6.33% (95% confidence interval, 6.20% to 6.46%).

Conclusions:

The prevalence and the predicted cumulative incidence are similar to rates reported in the international literature. The validity of the predicted cumulative incidence derived here is not known. If it were accurate, then the application of this method would represent a cost-effective alternative to incidence studies.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

References

1.Plowman, RP, Graves, N, Roberts, JA. Hospital Acquired Infection. London: Office of Health Economics; 1997.Google Scholar
2.Haley, RW. Managing Hospital Infection Control for Cost-effectiveness: A Strategy for Reducing Infectious Complications. Chicago: American Heart Association; 1986;Google Scholar
3.Plowman, R, Graves, N, Esquivel, J, Roberts, J. An economic model to assess the cost and benefits of the routine use of silver alloy coated urinary catheters to reduce the risk of urinary tract infections in catheterised patients. J Hosp Infect 2001;48:1:3342.CrossRefGoogle Scholar
4.Wenzel, RP. Nosocomial candidemia: risk factors and attributable mortality. Clin Infect Dis 1995;20:6:15311534.CrossRefGoogle ScholarPubMed
5.Haley, R. Cost benefit analysis of infection control activities. In: Brachman, P, Bennett, J, eds. Hospital Infections. Boston: Little, Brown; 1992:507532.Google Scholar
6.Nicholls, T, Morris, A. Nosocomial infection in Auckland Healthcare hospitals. N Z Med J 1997;110:1050:314316.Google ScholarPubMed
7.Rhame, F, Sudderth, W. Incidence and prevalence as used in the analysis of the occurrence of nosocomial infections. Am J Epidemiol 1981;113:111.CrossRefGoogle ScholarPubMed
8.Delgado-Rodriguez, M, Cueto-Espinar, A, Rodriguez-Contreras-Pelayo, R, Galvez-Vargas, R. A practical application of Rhame and Sudderth's formula on nosocomial infection surveillance. Rev Epidemiol Sante Publique 1987;35:482487.Google ScholarPubMed
9.Gastmeier, P, Brauer, H, Sohr, D, et al. Converting incidence and prevalence data of nosocomial infections: results from eight hospitals. Infect Control Hosp Epidemiol 2001;22:1:3134.CrossRefGoogle ScholarPubMed
10.Garner, J, Jarvis, R, Emori, T, Horan, T, Hughes, J. CDC definitions for nosocomial infections, 1988. Am J Med 1988;16:2840.Google ScholarPubMed
11.Emmerson, A, Entstone, J, Griffin, M, Kelsey, M, Smyth, E. The second national prevalence survey of infection in hospitals: overview of the results. J Hosp Infect 1996;32:3:175190.CrossRefGoogle ScholarPubMed
12.EPINE Working Group. Prevalence of hospital infections in Spain. J Hosp Infect 1992;20:113.CrossRefGoogle Scholar
13.Hovig, B, Lystad, A, Opsjon, H. A prevalence survey of infections amongst hospitalised patients in Norway. NIPH Annals 1981;4:4960.Google Scholar
14.Mayon-White, RT, Ducei, G, Kereselidze, T, Tikomirov, E. An international survey of the prevalence of hospital acquired infection. J Hosp Infect 1988;11(suppl A):4348.CrossRefGoogle ScholarPubMed
15.Haley, R, White, J, Culver, D, et al. The efficacy of infection surveillance and control programmes in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182205.CrossRefGoogle ScholarPubMed
16.Plowman, RP, Graves, N, Griffin, MAS, et al. The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. J Hosp Infect 2001;47:198209.CrossRefGoogle ScholarPubMed
17.Lang, S. Guide to Pathogens and Antibiotic Treatment. Auckland, New Zealand: Adis International; 2001.Google Scholar