Nosocomial surgical infections: incidence and cost in a developing country

ABSTRACT

Eight hundred twenty-nine patients were monitored for nosocomial surgical infections from January to December 1980 at the University Hospital of the West Indies. Two hundred twenty-five patients (27 percent) had 189 post-operative infections (POWI) and 295 other nosocomial infections with an average of 2.1 infections per infected patients. The incidence of POWI was 22.8 percent, varying from 7.3 percent in clean to 82.2 percent in infected wounds. The most common organisms isolated were gram-negative bacilli and Staphylococcus aureus. The most frequent nosocomial infection other than was urinary tract infection (27.8 percent). A statistically signifcant number of urinary tract infections and septicemias were associated with the use of medical devices such as indwelling urethral catheters and central venous pressure lines (p < 0.001). Septicemia was frequently associated with operations on the lower gastrointestinal and hepatobiliary tracts ( p < 0.001). The postoperative stay of an infected patient was prolonged by an average of 18 days. The total excess cost of hospitalization for the infected patients was U.S. $170,000 (AU).