In a prospective study, we determined that severity of underlying disease at time of admission indicates medical patients at unusual risk of nosocomial infection. The nosocomial infection rate was 23.6% in patients with fatal underlying disease, 9.6% in those with ultimately fatal disease, and 2.1% in those with nonfatal disease. After an awareness program that promoted the use of established methods for prevention of nosocomial infections was established, there was a decline of overall incidence of endemic nosocomial infections from 9.2% to 4.8% (P<.001) within an eight-month period. With subsequent discontinuation of the program, the infection rate rose to 8.1%. Reinstitution of the program resulted in a decline to 5.2% (P=.05).
(JAMA 239:1047-1051, 1978)
Britt MR, Schleupner CJ, Matsumiya S. Severity of Underlying Disease as a Predictor of Nosocomial InfectionUtility in the Control of Nosocomial Infection. JAMA. 1978;239(11):1047-1051. doi:10.1001/jama.1978.03280380047016