Is there an association between nosocomial infection rates and bacterial cross transmissions?
OBJECTIVE: Surveillance data of nosocomial infection rates are increasingly used for public reporting and interhospital comparisons. Approximately 15% of nosocomial infections on intensive care units are the result of patient-to-patient transmissions of the causative organisms. These exogenous infections could be prevented by adherence to basic infection control measures. The association between bacterial cross transmissions and nosocomial infection rates was analyzed. DESIGN: Prospective cohort study during 24 months. SETTING: Eleven intensive care units from two university hospitals. PATIENTS: All inpatients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary isolates of six indicator organisms (Acinetobacter baumannii, Enterococcus faecalis and E. faecium, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus) cultured from clinical samples or methicillin-resistant S. aureus surveillance testing of all inpatients were genotyped. Indistinguishable isolates in
