Descriptive study of nosocomial infections in a short-term inpatient behavioral health setting

Abstract

Background: Surveillance methods for nosocomial infections, with the use of a sound epidemiologic foundation, have not been published for behavioral healthcare settings. Methods: Nosocomial infection rates in a behavioral health care setting were quantified by integrating the following: (1) rounds/review of selected charts, (2) microbiology reports, and (3) records of antimicrobials dispensed. Incidence density rates were calculated with 1000 patient-days as the denominator. Results: The incidence of nosocomial infections of all types among all patients was 3.9 infections per 1000 patient-days. Rates among specific groups of behavioral patients ranged from children (6.4 infections per 1000 patient-days) to adults (3.9 infections per 1000 patient-days) to adolescents (3.2 infections per 1000 patient-days). Adult substance-abuse patients had a rate of 1.9 infections per 1000 patient-days. The most frequently diagnosed nosocomial infection among adult substance-abuse and behavioral patients was bronchitis at 0.5 and 0.6 infections per 1000 patient-days, respectively. The most frequently diagnosed nosocomial infection among adolescents and children was cellulitis at 0.6 and 1.3 infections per 1000 patient-days, respectively. Female patients experienced significantly more nosocomial infections than male patients, except among adult substance-abuse patients. Nosocomial infections usually occurred in patients who were hospitalized longer than the average length of stay, except among children. Conclusion: Nosocomial infections occur in behavioral health settings. Surveillance methods, with a sound epidemiologic foundation, must be developed. (Am J Infect Control 2001;29:275-80)