Objective To report type and rates of healthcare-associated infections (HAI) as well as pathogen distribution and antimicrobial resistance patterns from a pilot HAI surveillance system in Egypt. Methods Prospective surveillance was conducted from April 2011–March 2012 in 46 intensive care units (ICUs) in Egypt. Definitions were adapted from the CDC’s National Healthcare Safety Network. Trained healthcare workers identified HAIs and recorded data on clinical symptoms and up to four pathogens. A convenience sample of clinical isolates was tested for antimicrobial resistance at a central reference laboratory. Multidrug resistance was defined by international consensus criteria. Results ICUs from 11 hospitals collected 90,515 patient-days of surveillance data. Of 472 HAIs identified, 47% were pneumonia, 22% were bloodstream infections, and 15% were urinary tract infections; case fatality among HAI case-patients was 43%. The highest rate of device-associated infections was reported for ventilator-associated pneumonia (pooled mean rate: 7.47 VAP/1,000 ventilator-days). The most common pathogens reported were Acinetobacter spp. (21.8%) and Klebsiella spp. (18.4%). All Acinetobacter spp. isolates tested (31/31) were multidrug-resistant, and 71% (17/24) of Klebsiella pneumoniae isolates were extended spectrum beta-lactamase producers. Conclusions Infection control priorities in Egypt should include preventing pneumonia and preventing infections due to antimicrobial-resistant pathogens.
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