A program for surveillance of hospital-acquired infections in a general hospital: a two-year experience.

A program for surveillance of nosocomial infections was developed and carried out in six departments of Chaim Sheba Medical Center, Tel Hashomer, Israel. A team of nurse-epidemiologist made regular visits to the wards and the microbiology laboratory and recorded all episodes of nosocomial infections, which had been defined by a team of specialist from various hospitals and institutions in Israel. Monthly computerized reports were used to follow the pattern of hospital-acquired infections and the patterns of antibiotic sensitivity of the causative organisms. During a two-year period, 15,207 patients were admitted to the hospital and 1,851 episodes of nosocomial infection were reported-a rate of 12.2% for such infection. Postoperative wound infections were the most common infections in surgical services, accounting for between one-third and one-half of the total number of the infections among patients in these units. More than 50% of the infections in the intensive coronary care unit were located at iv sites. In the services for premature and newborn babies the most common infections were conjunctivitis and bacteriuria, the clinical significance of which is not clear. Between one-half and three-fourth of the nosocomial infections were caused by gram-negative organisms. Surgical wound infections were more common after extensive and lengthy operations. The risk of such infections usually increased with age of the patient and was higher after emergency surgery.