RESUMO
This study was undertaken to determine nosocomial bacterial infections (NI) in surgical patients in a developing country using the detailed option of the Center for Disease Control (CDC) surgical patient surveillance technique. From 1994 - 1995. Paediatrics surgical patients at the Lagos University Teaching Hospital (LUTH) were prospectively monitored for NI at all body sites. Standard definitions of NI were used, and NI sites were categorised by type of operation. A total of 304 NI occurred in 245 out of 664 surgical patients investigated. SSI (77.3 %) and urinary tract infections (19.1%) were in preponderance. Seventy three per cent of SSI were superficial incisions, 20.5% organ/space and 6.8% deep incisions. The overall wound infection rate was 30.9%. The SSI rate for emergency surgery was 35.6% and 26.5% for elective procedures. Rates within each wound class were 20.2, 23.8, 51.9 and 52.8% respectively and 17, 37.6, 43.4 and 47. 1% for patients with ASA scores of I II III and IV in that order. The SSI rates for patients with scores of 0, 1, 2 and 3 were 20.4; 43.5, 57.1 and 75% respectively. Mean infection rates in the various wound classes were highly correlated with the number of risk factors present. Klebsiella pneumoniae (38. 7%), Escherichia coli (22.7%), Pseudomonas aeruginosa (16.8%) and Staphylococcus aureus (10. 7%) were the most common pathogens.
Assuntos
Bactérias Aeróbias , Infecções Bacterianas/epidemiologia , Infecção Hospitalar/epidemiologia , Hospitais Universitários/estatística & dados numéricos , Centro Cirúrgico Hospitalar/estatística & dados numéricos , Criança , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Vigilância da População , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricosRESUMO
Beta-lactamase production was investigated in 1033 bacterial pathogens--262 gram-positive bacteria, 482 Enterobacteriaceae, 289 non-fermenting bacilli. These were isolated from nosocomial infections in paediatric patients. Beta-lactamase was detected using chromogenic cephalosporin and starch paper methods. More than 80% of the isolates produced the enzyme, which was not detected in enterococci and streptococci. There was no appreciable difference ([symbol: see text] 2 = 5.31, P > 0.05) in the number of Beta-lactamase producers obtained using the two methods. Great caution must be exercised in the therapeutic use of Beta-lactam drugs for nosocomial bacterial infections.