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Sjukhusinfektioner: systematisk observation sänker antalet smittade

Systematisk observation och registrering av nosokomiala infektioner minskar inom några år avsevärt antalet sjukhusinfektioner enligt en undersökning av den tyska Nosokomiala Infection Surveillance System "Krankenhaus-Infektions-Surveillance-System".

Exakt observation minskar smittade betydligt.

Systematic observation and recording of nosocomial infections significantly reduce in-hospital infection rates within a few years, according to an analysis of the collected data of the German Nosocomial Infection Surveillance System “Krankenhaus-Infektions-Surveillance-System (KISS)”. The incidence of ventilator-associated pneumonia (VAP) decreased by 29% within three years, and central catheter-associated infections and postoperative wound infections were reduced by 20% and 28% respectively. 

KISS was started in Germany in 1997. The number of participating hospitals has since increased steadily. Prof. Petra Gastmeier and her colleagues at School of Medicine, Hanover, Germany, have investigated whether this has had an impact on the incidence of nosocomial infections (J Hospital Infect 2006; 64: 16-22). In their analysis the investigators only included hospitals that had been taking part in KISS for an uninterrupted period of at least three years (150 intensive care wards and 133 departments of surgery). They compared the infection rates recorded for the first year of the observation period with the second and third year data.

In the first year of participation in KISS, the ventilator-associated pneumonia (VAP) rate was 11.2 per 1,000 ventilation days, the rate of central catheter-associated infections was 2.1 per 1,000 catheter days, and the rate of postoperative wound infections was 1.6 per 1,000 operations. The incidence of nosocomial infections decreased significantly in the second and third years. In the third year the ventilator-associated pneumonia (VAP) rate was 8.0 per 1,000 ventilation days (minus 29%); central catheter-associated infections were observed on as few as 1.7 out of 1,000 catheter days (minus 20%); and the number of postoperative wound healing impairments decreased to 1.1 per 1,000 operations (minus 28%).

“This significant reduction in nosocomial infections points up the importance of close observation and recording for successful infection control. Participation in KISS actively encourages hospitals to implement measures and controls aimed at reducing infection risk”, concluded the authors of the study. The time and effort put into such programs pays off for the hospitals, because due to the reduction of infections the treatment costs can be reduced significantly.