[Nosocomial infections at a neurologic hospital, analysis of 10 years].

OBJECTIVE: To describe the results of 10 years of nosocomial infection (NI) surveillance at a neurological center and evaluate the impact of control measures.

PATIENTS AND METHODS: A descriptive and retrospective study was performed at a reference center for adult neurologic and neurosurgical patients located in Mexico City. Between 1990 and 2000, the number, site and type of NI were registered. Chi Square test was employed for statistical analysis of numerical data.

RESULTS: Mean NI rate observed was 21 episodes per 100 discharges, with a 40% reduction during the period. Predominant NI were urinary tract infections (36%), lower respiratory tract infections (31%), phlebitis (9%), primary bacteremia (7%), surgical wound infections (7%), and pneumonia (4%). Control measures with a definite impact were organization of intravenous therapy teams with reduction in bacteremia (p = 0.009). Changes in preoperative care, hair clipping instead of shaving, clorhexidine shampoo, and technique of long tunneled ventriculostomy with a 57% reduction (p = 0.00006) in infections related with neurosurgical procedures. The increase in staff and equipment renewal of the respiratory therapy service decreased respiratory infections.

CONCLUSIONS: The measures that reduced our NI rate may be useful in other centers for neurologic patients.