Journal of Bacteriology & Parasitology

Abstract

Nosocomial Infections Incidence Rates, Bulgaria, 1999-2011

Todorova-Christova M, Vatcheva R, Filipova R, Kamenova T, Arnaudov Y, Radulova Y, Ivanov I and Dobreva E

The study presents an analysis in two parts of the officially registered NI in the country by the computerized information system (CIS-NI) in the course of a 13-year period (1999-2011). The system employs two types of indicesincidence rate (morbidity, recalculatred in the study per 1000 patients discharged) and percentage distribution (frequency distribution, relative frequency distribution) by infection sites and microbial agents. This part discusses the overall NI incidence rates by hospital and wards categories, accentuating upon pediatric and intensive care wards-anesthesiology and resuscitation, intensive therapy.

The average incidence rate is 10% at the following distribution by infection sites: VAP-5%, surgical site infections (SSI) and pulmonary infections (the latter including bronchitis, bronchiolitis, pneumonia, non-associated with procedure of endotracheal intubation) of 16-18% each; urinary tract infections (UTI) 13-15%; sepsis 4-5%, enteric, skin infections, of the sense organs, intraabdominal and cardiovascular system infections-approximately 2% of each group, endometritis and other gynecologic infections-1%, mastitis in young mothers-0.1%. Microbiologically diagnosed are 50-60% ?f the infections as a total and in 40-50% unconfirmed and unexamined microbiologically.

E. coli and S. aureus are identified in about one third of the total number of infections, the rest isolates pertain to opportunistic bacterial species, known for their multiresistence: Klebsiella spp, Pseudomonas spp, Acinetobacter spp etc.

The incidence rate of infections ranges within low limits, e.g, LRTIs (pulmonary infections)-pediatric wards-upto 3%; VAP/ pulmonary infections-resuscitation (A&R) 15-19%, intensive therapy (IT) 5-8%; UTIs-resuscitation, urology-13%; SSIs-burn units-38%, septic surgery-23%, vascular surgery-11%; sepsis-burn units-22%, resuscitation-8%, cardiovascular surgery-6%, ICUs-5%.

The official registration system provides reliable information on a national level for the purpose of NI surveillance and control. The system interpretes the original data of the wards in basic indices as incidence and microbial isolates‘ distribution. This official database reflects the efforts in the sphere of NI prevention and control. Possible additional links to the system would contribute to direct comparisons of indices regarding the care for patients undergoing risk procedures.