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Original Article

Korean J healthc assoc Infect Control Prev 2011; 16(2): 54-62

Published online December 30, 2011 https://doi.org/10.14192/kjicp.2011.16.2.54

Copyright © Korean Society for Healthcare-associated infection Control and Prevention

Healthcare-Associated Infection Surveillance in Small and Medium Sized Hospitals

Eun Suk Park1, Hye Young Jin2, Sun Young Jeong3, Oh Mee Kweon1, So-Yeon Yoo4, Shin Yong Park5, Sung Ran Kim6, Hae Kyung Hong7, Og Sun Kim8, Kyung Mi Kim9, Sung Won Yoon10, Jae Sim Jeong11, Dongeun Yong12, Muyng Soo Kim13, Dae-Won Park14, Yong Kyun Cho15, Hyang Soon Oh16, Joon-Sup Yeom17, and Eui-Chong Kim18

Infection Control Office, Severance Hospital1, Ajou University Hospital2, Ewha Womans University Mokdong Hospital3, The Catholic University of Korea, St. Vincent's Hospital4, Department of Quality Improvement, Gachon University Gil Hospital5, Infection Control Office, Korea University Guro Hospital6, Office of Infection Control, Gwandong University College of Medicine Myongji Hospital7, Department of Nursing, Youngdong University8, Department of Nursing, Semyung University9, Infection Control Office, Samsung Medical Center10, School of Clinical Nursing, University of Ulsan11, Department of Laboratory Medicine, Yonsei University, College of Medicine12, Department of Internal Medicine, Gwangmyung Sungae Hospital13, Devision of Infectious Disease, Korea University College of Medicinel14, Devision of Infectious Disease, Gachon University pf Medicine and Science15, Infection Control Office, Seoul National University Hospital16, Department of Internal Medicine, Kangbuk Samsung Hospital17, Department of Laboratory Medicine, Seoul National University College of Medicine18, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The purpose of this study is to know the healthcare-associated infection (HAI)s in small and medium sized hospitals, less than 400 beds.
Methods: We had web based surveillance for HAIs in 27 hospitals from August to October 2010. The surveillance performed in 1-2 ICUs and 1 general ward in each hospitals by CDC definition. And for the multi-drug resistant organisms (MDROs), we reviewed all of blood culture results.
Results: We identified 319 HAIs among 269,436 patients days. The HAIs rate was 1.18 (CI 1.05-1.32)/1,000 patient- days. Urinary tract infection was the most common HAI (52.4%) in this study followed by pneumonia (18.9%), bloodstream infections (14.2%), surgical site infection (7.9%), and others (6.6%). There were 76.5% of device associated infections in UTI, 46.7% in BSI, and 18.3% in pneumonia. The rate of HAIs in ICU was higher than that of in general ward (4.6 vs 0.9/1,000 patient-days). However, the indwelling catheter associated urinary tract infection rate was lower in ICU (2.6 vs 4.4/1,000 device days). There were no significant differences in central line-associated blood stream infection rate (1.5 vs 1.8) and ventilator-associated pneumonia rate (3.0 vs 0.0). The common microorganisms found in HAIs were Escherichia coli (19.8%), Staphylococcus aureus (13.1%), and Pseudomonas aeruginosa (12.7%). Moreover, 90.9% of S. aureus were resistant to methicillin, and 38.2% of P. aeruginosa and 44.4% of Acinetobacter baumannii were resistant to imipenem. Total of 66 MDROs were isolated from blood culture and the result shows that the MRSA was 84.6% (56 case), carbapenmen-resistant Acinetobacter spp. was 10.6% (7 case), and vancomycin-resistant enterococci was 4.6% (3 case).
Conclusion: The characteristics of HAIs in small and medium sized hospitals will be contributed to the decision making of governance policy for infection control and to provide comparable data for these hospitals.

Keywords: Small hospital, Healthcare-associated infection, ICU, Multidrug resistant organisms

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