The Incidence of Nosocomial Infection at the Rehabilitation Medicine Ward of a Tertiary Government Hospital

Abstract

Objective. This prospective cohort study was undertaken to determine
incidence of hospital acquired infection among patients admitted to
the Rehabilitation Medicine Ward at the Philippine General Hospital.
Methods. The 70 participants were all patients admitted to the
Rehabilitation Medicine Ward during the study period of three months,
from September to November 2008. Baseline complete blood count,
urinalysis and chest x-ray were determined on admission, to rule out
community acquired infections. The patients were observed during
admission at the ward if they develop any infection through signs and
symptoms and subsequent laboratory work up for infection. If fever,
difficulty of breathing or dysuria were noted during the first 48 hours,
the case was excluded and was considered community acquired upon
confirmation of infection. If signs and symptoms of infection were
noted beyond 48 hours, the infection was considered nosocomial.
Validation was through appropriate laboratory workup.
Results. The average length of hospital stay was 28.37 days. Only
three of the 70 subjects developed nosocomial infections; two had
cerebrovascular disease (CVD) and one had spinal cord injury (SCI). All
three had urinary tract infections. The two CVD patients had indwelling
catheters while the patient with SCI was undergoing self clean
intermittent catheterization. The three developed infection at various
days of stay: 5th, 9th and 17th days. The length of stay of the three
patients with nosocomial infection was an average of 30 days, similar
to the average stay of 28 days for all admissions. The study showed that
the Rehabilitation Medicine Ward had a nosocomial infection incidence
rate of 4.29% of total admissions and 15.79% of total catheterized
patients for nosocomial infection attributed to catheterization.
Conclusion. The study revealed a low incidence of nosocomial infection,
all urinary. The study alerts the rehabilitation health workers handling
inpatients on catheterization, especially older patients, to be vigilant
and to anticipate urinary tract infections.