Nosocomial respiratory infections at a multi-field hospital

Abstract

We studied 94,182 patients treated in 9 specialized departments of the Barnaul Railway hospital from 1994 to 2002 to detect the incidence and causes of nosocomial respiratory infections (NRI) and to evaluate the NRI clinical manifestations and outcomes. The NRI were found in 1,871 (1.99 %) patients. The NRI were presented mainly by acute respiratory infections of the upper airways (1.92 %) and rarer by nosocomial pneumonia (0.06 %). They had different etiology, clinical features and outcomes. The acute NRI were established to occur twice more frequently in winter (from October to March) depending on epidemiologic situation at the region, social and occupational status of the patients (frequently among the railway transport service staff). Chronic obstructive bronchitis background and violation of epidemiologic regimen (bringing the infection with newly admitted patients) were predisposing factors. Nosocomial pneumonia was mostly observed in patients of a resuscitation unit (more than 2/3 of the patients), predisposing factors were severe concomitant illnesses, repeated surgical intervention, elderly and senile age. Mycoplasma as an etiological factor of the nosocomial acute respiratory infection (ARI) was observed rarer (in 17.0 % of the patients) than in community-acquired ARI and much more rarer in nosocomial pneumonia (9.1 %) as compared with community-acquired pneumonia (21.6 %).