Objectives: We report the results of a 4-month survey implemented at the urologic clinic of an Italian university hospital, with the following aims: (1) to describe the incidence of nosocomial infections (NI) in our setting for comparison within and between urologic wards and (2) to provide relevant information to monitor and target infection control policies. Methods: A 4-month prospective survey was performed from April to July 2004, preceded by the 1-month surveillance pilot study; both performed in accordance with the methods, protocols and definitions of the National Nosocomial Infections Surveillance System. The following indicators were included site-specific incidence rates and device-adjusted infection rates. For surgical site infections, rates were calculated by operative procedure and risk index category. Antimicrobial usage was also monitored. Results: Incidence of symptomatic urinary tract infections was 1.4 per 1000 patient-days, 1.3 per 100 catheterized patients and 3.0 per 1000 urinary catheter-days. Incidence and incidence density of surgical site infections were respectively 1.3 per 100 patients and 1.8 per 1000 patient-days. Conclusions: Our study represents a contribution to improve the quality of care in our urologic ward by monitoring the size of the NI problem using standardized definitions, data collection and indicators to compare the results of the unit with possible future ones, and by identifying practices that should be changed. This study supports close surveillance of antibiotic administration among urologists who may be unaware of the inappropriate antibiotic administration in their patients. Two major items were identified for planning future intervention: focusing on the use of closed urinary drainage systems and on appropriate antimicrobial prophylaxis. Notes: European Urology, the Platinum Journal, the official journal of the EAU (European Association of Urology), has been a prestigious urological forum for over 35 years, and is currently read by more than 20,000 urologists across the globe. With an impact factor of 8.843, the journal has become the leading scientific publication in the field. The Article published by Agodi et al. (first Author and corresponding Author) has been focused by a dedicated Editorial Comment, by Alberto Trinchieri (Trinchieri A, Eur Urol 2007; 51: 253-254), highlighting the relevance, the international value and the novelty of the paper addressing the relevant issue of the risk of nosocomial associated urinary tract infections (UTIs) and of their control in a urological department. UTIs have been reported to account for about 40% of nosocomial infections and particularly urological patients have several risk factors for developing UTI. For this reason the prevalence of UTIs has become an important quality parameter of urological surgery. In fact the Pan-European survey carried out by the European Society for Infections in Urology found that about 10% of urological patients had a nosocomial associated urinary tract infection (presented at the Congress of European Association of Urology, Vienna, Austria, 24–27 March 2004). As a novel and plus result, the authors report rates of infection, expressed as both cumulative incidence and incidence density of nosocomial infections, that are much lower than the rates expected on the basis of previous reports. This paper confirms the need for a revision of epidemiological definitions of UTIs in Urology and the request of a more stringent antibiotic policy in urological services aiming to introduce recommendations for antibiotic prophylaxis or the so called antimicrobial stewardship. Furthermore, due to the excellance of the paper and of her published research on this field, Antonella Agodi has been invited by the Editor-in-Chief of InTech - Open Access Publisher, to give her contibution in the book entitled “Clinical Management of Complicated Urinary Tract Infection”, writing a chapter entitled “Epidemiology and Control of Urinary Tract Infections in Intensive Care Patients” (Agodi A and Barchitta M. Epidemiology and Control of Urinary Tract Infections in Intensive Care Patients. In Clinical Management of Complicated Urinary Tract Infection, ISBN 978-953-307-393-4, September 2011).
|Titolo:||Active surveillance of nosocomial infections in urologic patients|
|Data di pubblicazione:||2007|
|Appare nelle tipologie:||1.1 Articolo in rivista|