Bacteriëmie in twee algemene ziekenhuizen: het topje van de ijsberg van ziekenhuisinfecties

H.A. Verbrugh, A.J. Mintjes-de Groot en D.A. Broers

Bacteraemias in two general hospitals; the tip of the iceberg.

– 197 episodes of bacteraemia occurred in one year in 174 patients admitted to two general hospitals. The sources of infection and the times of occurrence were studied. The incidence of bacteraemia was 1.15 per 100 admissions in the larger university-affiliated hospital and 0.84 per 100 admissions in the smaller non-teaching hospital. 43 of these bacteraemias were due to urogenital tract infections, virtually always caused by Escherichia coli and other Gram-negative bacteria of the family of Enterobacteriaceae. In 20 of the bacteraemias, the source of infection was an infected wound, a decubitus ulcer or an intravascular catheter. Staphylococcus aureus and Staphylococcus epidermidis were the predominant causative agents isolated in these cases. 29 of the 174 patients (17) died, 23 (13) of them as the consequence of the sepsis. 68 of the bacteraemias could be classified as nosocomial. A system of actively recording nosocomial infections revealed an infection rate of 7.1 per 100 admissions in 1984 in the smaller hospital; 57 of these involved the urinary tract.

Future efforts to curb hospital-acquired infection should focus on urinary tract infections and infections of intravascular catheters, wounds and other skin defects. A continuous active surveillance system for hospital-acquired infections is of prime importance.