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The prevalence of nosocomial and community‐acquired infections in Australian hospitals

The first national survey of the prevalence of nosocomial and community‐acquired infections in Australian hospitals was carried out during July 1984. Data were collected on 28 643 patients in rural and metropolitan, public and private acute‐care hospitals. The over‐all adjusted prevalence of nosocomial infections was 6.3%; the prevalence of community‐acquired infection was 9.7%. A total of 5940 infections occurred; 39% were hospital‐ acquired infections and 61% were community‐acquired infections. These occurred at the following sites: the respiratory tract, 35.4% (2100 infections; contributing 19% of hospital‐acquired infections and 46% of community‐acquired infections); the urinary tract, 15.1% (896 infections; contributing 22% of hospital‐acquired infections and 11% of community‐ acquired infections); surgical wounds, 13.4% (797 infections; contributing 34% of hospital‐acquired infections); the gastrointestinal tract, 7.8% (466 infections; contributing 3.4% of hospital‐acquired infections and 11 % of community‐acquired infections); skin, 6.3% (376 infections; contributing 4.4% of hospital‐acquired infections and 8% of community‐acquired infections); abscesses, 1.9% (113 infections; contributing 0.9% of hospital‐acquired infections and 2% of community‐acquired infections); traumatic wounds, 1.5% (90 infections; contributing 0.9% of hospital‐acquired infections and 2% of community‐acquired infections); bacteraemia, 1.5% (89 infections; contributing 1.6% of hospital‐acquired infections and 1% of community‐ acquired infections); burns, 0.2% (14 infections; contributing 0.3% of hospital‐acquired infections and 0.2% of community‐acquired infections); and others, 16.8% (999 infections; contributing 13.4% of hospital‐acquired infections and 19% of community‐acquired infections). There was a significant association between hospital size and infection rates. The nosocomial infection prevalence rate increased from 4.2% in hospitals with 50‐99 beds to 7.6% in hospitals with 500 or more beds. The prevalence of community‐ acquired infections was higher in rural (11.5%) than in metropolitan (8.7%) hospitals. After adjusting for hospital size, public hospitals had significantly‐ higher prevalences of nosocomial (6.7%) and community‐acquired (10.6%) infection than did private hospitals (nosocomial infection, 4.8%; community‐ acquired infection, 6.3%).