Medical Microbiology

(ff) #1
344 4 BacteriaasHumanPathogens

Therearenoreliablefiguresavailableonviralnosocomialinfections.Arough
estimateputsviralnosocomialinfectionsatlessthan 1 %ofthetotal.Anex-
ampleofaviralnosocomialinfectionisinfectioushepatitistransmittedby
bloodorbloodproducts.
&Bacteriaarethemainpathogensinvolvedinnosocomialinfections.Most
ofthecausativeorganismsarefacultativelypathogenic(opportunistic)bac-
teria,whicharefrequentlyresistanttomanydifferentantibiotics.Thesebac-
teriahavefoundnichesinwhichtheypersistasso-calledhospitalflora.The
resistancepattersseeninthesebacteriareflecttheoftenwidevariationsbe-
tweenanti-infectiveregimensaspracticedindifferenthospitals.
&Fungi.Fungalnosocomialinfectionshavebeenontheincreaseinrecent
years.Itcanbesaidingeneralthattheyaffectimmunocompromisedpatients
andthatneutropenicpatientsareparticularsusceptible.
Table4. 17 liststhepathogensthatcausethemostsignificantnosocomialin-
fectionsasdeterminedinaprevalencestudydoneinGermany(Eastand
West)in 1995 (NIDEPStudy).
Table4. 18 showstheprevalencelevelsatwhichnosocomialinfectionsoc-
curredin 72 selectedhospitalsonagivendateintheabovestudy.Thepre-
valenceandpathogendatashownhereapproximatewhatotherstudieshave
found.Prevalenceandincidencelevelscanvaryconsiderablyfromhospitalto

Table4. 18 Frequency(prevalence)oftheMostImportantNosocomialInfec-
tionTypes(%)^1

Infection Internal
medicine

Surgery Gyneco-
logy

Intensive
care

All
patients

Urinarytractinfections 1 .5 7 1 .45 0.9 1 2.35 1 .46
Lowerrespiratorytract
infections

0.63 0.30 0.09 9.00 0.72

Postoperativewound
infections

0.03 1 .34 0.05 1 .3 7 0.55

Primarysepsis 0.3 1 0. 15 0. 14 2. 15 0.29
Otherinfections 0.52 0.7 4 0.2 7 1 .96 0.62
Patientswithatleast
oneinfection

2.9 7 3.80 1 .45 1 5.30 3.46

(^1) Figuresfrom“NosokomialeInfektioneninDeutschland–ErfassungundPrevention
(NIDEP–Studie).”Vol.56,PublicationSeriesoftheGermanFederalHealthOffice.
NomosVerlagsgesellschaft,Baden-Baden, 1 995.
4
Kayser, Medical Microbiology © 2005 Thieme

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