ABSTRACT
INTRODUCTION: Nosocomial infections (NI) are significant medical problem in the countries worldwide. NI significance reflects in higher morbidity and mortality rates, and moreover, NIs add to longer stay and higher treatment costs. Based on data obtained from underdeveloped and developing countries, over 20% of hospitalized patients acquire some of NIs, while that proportion is 5% in developed countries. OBJECTIVE: A) to establish the frequency of noosocomial infections at the Clinic of Digestive System Diseases, b) determine the NI incidence in accord with anatomic localizations, c) evaluate the percentage prevalence of NI causes according to anatomic localizations, and d) review the problem of resistance of NI causative agents. MATERIAL AND METHODS: The study of NI incidence was calculated by Center for Diseases and Prevention (CDC) methodology. Sampling, cultivation, isolation, identification and sensitivity tests of cauosative agents to antimicrobial drugs, obtained from patient's material, were carried out by standard microbiological methods in Microbiological laboratory of the Emergency Center, Clinical Center of Serbia. All infections in patients hospitalized at the Clinic of Digestive System Surgery in 2007 were recorded. Data available from medical documentation as well as data obtained from interviews of medical personnel were analyzed. RESULTS: The incidence rates of patients with NI ranged from 1.7-3.4 per 1000 hospital days. Out of a total number of recorded nosocomial infections, surgical site infections accounted for 69%, blood infections 23% and urinary tract infections 6.8%. The most frequent causative agents of surgical site infections in the last year were as follows: Pseudomonas spp (19%), followed by Staphylococcus aureus and Klebsiella spp--(18%), Acinetobacter spp (13%), and Enterococcus spp (8%). Forty percent (40%) of all blood infections verified by laboratory tests in 2007 was caused by coagulase negative Staphylococcus spp (CNS), followed by Acinetobacter spp (18%). Enterococcus spp (11%), and Staphylococcus aureus (7%). The most frequent causative agents of urinary infections were: Escherichia coli (35%) and Enterococcus spp (29%). Over 80% of Staphylococcus aureus isolates were resistant to Methicillin (MRSA) and enterobacteria produced by beta lactamase were recorded (ESBL). CONCLUSION: Enforcement of epidemiological surveillance of nosocomial infections contributes to insight of severity of NI problem, recognition of resistance of causative agents to antibiotics and recommendation of specific preventive measures related to these infections.
