The preventable proportion of nosocomial infections: an overview of published reports

J Hosp Infect. 2003 Aug;54(4):258-66; quiz 321. doi: 10.1016/s0195-6701(03)00150-6.


The proportion of nosocomial infections potentially preventable under routine working conditions remains unclear. We performed a systematic review to describe multi-modal intervention studies, as well as studies assessing exogenous cross-infection published during the last decade, in order to give a crude estimate of the proportion of potentially preventable nosocomial infections. The evaluation of 30 reports suggests that great potential exists to decrease nosocomial infection rates, from a minimum reduction effect of 10% to a maximum effect of 70%, depending on the setting, study design, baseline infection rates and type of infection. The most important reduction effect was identified for catheter-related bacteraemia, whereas a smaller, but still substantial potential for prevention seems to exist for other types of infections. Based on these estimates, we consider at least 20% of all nosocomial infections as probably preventable, and hope that this overview will stimulate further research on feasible and cost-effective prevention of nosocomial infections for daily practice.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / etiology
  • Bacteremia / prevention & control
  • Catheters, Indwelling / adverse effects
  • Cost-Benefit Analysis
  • Cross Infection / epidemiology
  • Cross Infection / etiology
  • Cross Infection / prevention & control*
  • Cross Infection / transmission
  • Disease Transmission, Infectious / prevention & control
  • Feasibility Studies
  • Humans
  • Infection Control / organization & administration*
  • Program Evaluation
  • Research Design
  • Risk Factors