High Level of Gastrointestinal Nosocomial Infections in the German Surveillance System, 2002–2008
Creators: name: Spackova, Michaela
name: Altmann, Doris
name: Eckmanns, Tim
name: Koch, Judith
name: Krause, Gérard
Publisher: name: Robert Koch-Institut, Infektionsepidemiologie
Year: 2010
Subjects: subject: Adolescent
subject: Humans
subject: Female
subject: Gastroenteritis/epidemiology
subject: Germany/epidemiology
subject: Hospitals
subject: Male
subject: Middle Aged
subject: Risk Factors
subject: Child
subject: Adult
subject: Sentinel Surveillance
subject: Norovirus/isolation &amp; purification
subject: Aged
subject: Infant
subject: Salmonella/isolation &amp; purification
subject: Age Distribution
subject: Multivariate Analysis
subject: Cross Infection/microbiology
subject: Young Adult
subject: Cross Infection/epidemiology
subject: Child Preschool
subject: Rotavirus Infections/epidemiology
subject: Campylobacter Infections/epidemiology
subject: Infant Newborn
subject: Geography
subject: Salmonella Infections/epidemiology
subject: Gastroenteritis/microbiology
subject: Rotavirus/isolation &amp; purification
subject: Campylobacter/isolation &amp; purification
subject: Campylobacter Infections/etiology
subject: Rotavirus Infections/etiology
subject: Salmonella Infections/etiology
subject: 610 Medizin

description: Objective: Surveillance of nosocomial infections (NIs) is well established in many countries but often does not include gastrointestinal infections. We sought to determine the proportion of NIs among all hospitalized cases for the 4 most prevalent types of gastrointestinal infections in Germany. Methods: We analyzed all notifications of laboratory-confirmed or epidemiologically linked gastrointestinal infections due to norovirus, rotavirus, Salmonella species, and Campylobacter species reported to the Robert Koch Institute in Berlin, Germany, from 2002 through 2008. Infections were considered nosocomial if disease onset was more than 2 days after hospitalization for norovirus, rotavirus, and Salmonella infection and more than 5 days after hospitalization for Campylobacter infection. Results: During the study period, 710,725 norovirus, 394,500 rotavirus, 395,736 Salmonella, and 405,234 Campylobacter gastrointestinal infections were reported. Excluding cases for which nosocomial status could not be determined, we identified 39,424 (49%) of 80,650 norovirus, 11,592 (14%) of 83,451 rotavirus, 3,432 (8%) of 43,348 Salmonella, and 645 (2%) of 33,503 Campylobacter gastrointestinal infections as definite nosocomial cases. Multivariate analysis confirmed higher risk of gastrointestinal NIs for patients aged more than 70 years (relative risk [RR], 7.0 [95% confidence interval {CI}, 6.7-7.2]; [Formula: see text]) and residents of western states (RR, 1.3 [95% CI, 1.2-1.3]; [Formula: see text]) and lower risk for female patients (RR, 0.9 [95% CI, 0.9-0.9; [Formula: see text]). Yearly NI proportions remained stable except for norovirus. Conclusions: The investigated gastrointestinal NIs in Germany do not show a clear trend, but they are at high level, revealing potential for public health action and improvement of hospital infection control mainly among older patients. National prevalence studies on gastrointestinal NIs would be of additional value to give more insight on how and where to improve hospital infection control.