Public Health Laboratory Service. Infections acquired in medical wards

Abstract

A co-operative study was made of the incidence of infection acquired by patients in medical wards. Records were collected of 6740 admissions to 21 wards in 13 hospitals. There were 384 clinical infections (5·7 per 100 patients admitted); 135 of them (35%) were infections of the lower respiratory tract, 72 (19%) were septic skin lesions or infected wounds, and 81 (21%) were urinary tract infections. Infection was believed to have contributed to the death of 59 patients—17% of those infected or 8% of those dying in hospital. Nearly three-quarters of the deaths were attributed to ‘pneumonia’. Acquired infections were most common and most severe at the extremes of age. There was an excess of males over females in staphylococcal infections and in infections of the lower respiratory tract, and of females over males in urinary tract infections. The incidence of infection was above average in patients suffering from malignant disease, diabetes, rheumatoid arthritis, cerebral thrombosis and haemorrhage, and from diseases of the urinary tract and of the skin. There were 110 acquired infections with Staph, aureus and 12 deaths were attributed to them. Over half of these infections were due to staphylococcal strains which caused only one clinical infection in a ward in the course of a year. Pneumonia was difficult to diagnose in severely ill or moribund patients, and its clinical significance was hard to assess. It was not possible to obtain a reliable estimate of the part played by bacterial infection in its causation.