Nosocomial outbreaks: the Centers for Disease Control's hospital infections program experience, 1980-1990

Article Abstract:

Nosocomial infections are infections that are acquired in the hospital. They are an important health concern because they are a major cause of morbidity and prolonged hospitalization. Between 1980 and 1990, the Centers for Disease Control investigated 125 nosocomial infection outbreaks as a part of their Hospital Infections Program. Of the 125 outbreaks, 77 were caused by infections with bacteria, 11 were caused by infections with viruses, five were caused by infections with mycobacteria, and 22 were caused by bacterial toxins or other microorganisms. Most of the bacterial infections were caused by Gram-negative bacteria, and most of the fungal infections were caused by Candida and Aspergillus. Twenty-eight of the outbreaks were caused by contaminated products, such as medications, antiseptics, solutions, red blood cells used for transfusions, and hospital equipment. There were three cases of vitamin E toxicity in premature infants caused by a vitamin E preparation called E-Ferol, three cases of contaminated antiseptic solution called povidone-iodine, and seven cases of sepsis (bacteria in the blood) caused by red blood cells contaminated with Yersinia enterocolitica. There were 14 outbreaks related to instruments or devices and 16 related to specific medical procedures. In 1987, an outbreak of otitis media (middle ear infection) involving 17 patients occurred in a private medical practice. The infections were caused by contaminated water used to wash ears and contaminated suctioning equipment. Between 1986 and 1990, the proportion of outbreaks related to devices, procedures and contaminated products increased by 20 percent. The investigation of nosocomial infection outbreaks provides information about the cause and source of infection and can be used to develop methods for preventing future outbreaks. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, United States. Centers for Disease Control and Prevention

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Major trends in the microbial etiology of nosocomial infection

Article Abstract:

Infections that are acquired during hospitalization (nosocomial infections) represent a major health concern. It is estimated that 3 to 5 percent of all patients who spend time in the hospital develop an infection during their stay. There are many different types of microorganisms present in the hospital environment that can cause nosocomial infections. Escherichia coli is a type of bacteria that is widely distributed in nature and is a natural part of the human digestive tract. It is the most common cause of nosocomial infections. Pseudomonas aeruginosa, Staphylococcus aureus and other types of bacteria called enterococci account for more than 10 percent of all nosocomial infections. Other microorganisms among the 10 most common causes of nosocomial infections are Klebsiella pneumoniae, Candida albicans, Enterobacter species, and streptococcal species. These microorganisms can cause urinary tract infections, pneumonia, wound infections, and blood infections. Between 1980 and 1989, significant changes have occurred regarding the prevalence of infections caused by these microorganisms. During this period, the percentage of nosocomial infections caused by Escherichia coli has decreased from 23 percent to 16 percent, and infections caused by Klebsiella pneumoniae decreased from 7 to 5 percent. At the same time, the percentage of infections caused by certain types of staphylococci has increased from 4 to 9 percent, and infections caused by Candida albicans have increased from 2 to 5 percent. These findings may be explained by more successful prevention of Escherichia coli and Klebsiella pneumonia infections, and by an increase in the number of microorganisms that have become resistant to treatment with antibiotics. Prevention of nosocomial infections should be a primary goal over the next decade. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Bacterial infections

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