Device-Associated Nosocomial Infection Rates and Distribution of Antimicrobial Resistance in a Medical-Surgical Intensive Care Unit in Turkey

Abstract

SUMMARY:The aim of this study was to explore the rate of device-associated nosocomial infections (DANIs) and the distributions of causative agents and patterns of antibiotic resistance in the medicalsurgical intensive care unit (ICU) over a 3-year period and to compare these rates with those reported by National Nosocomial Infections Surveillance System and International Nosocomial Infection Control Consortium. A total of 1,798 patients were hospitalized in our ICU for 13,942 days, of which 309 patients had DANIs, indicating an overall infection rate of 22.1 per 1,000 ICU-days. The central lineassociated bloodstream infection rate was 6.4 per 1,000 catheter-days, whereas the ventilator-associated pneumonia rate was 14.3 per 1,000 ventilator-days and the catheter-associated urinary tract infection rate was 4.3 per 1,000 catheter-days. Overall, 87.4z of all Staphylococcus aureus DANIs were caused by methicillin-resistant strains. With respect to Pseudomonas aeruginosa, 30.9z of the strains were resistant to ciprofloxacin, 23.3z to amikacin, 43.1z to ceftazidime, 19.1z to piperacillin-tazobactam, and 34.7z to imipenem. Furthermore, 1.9z of the Enterococcus spp. were resistant to vancomycin, and 51.1z of Enterobacteriaceae were resistant to ceftriaxone. DANI rates decreased over the 3-year study period, which was likely in response to the infection control measures implemented in our ICU.

Increase in catheter associated urinary tract infections in intensive care units at a tertiary care centre: a cause of concern

“…This is in consistent with the findings of the previous studies [16,17]. This may be attributed to the fact that, Candida species, a normal genital flora becomes pathogenic under various factors like prolonged catheterization, surgery, broad spectrum antibiotics etc.…”

“…Among the Gram positive isolates, Enterococcus spp. was most frequently isolated which is in consistent with the study by other authors [16,17]. NHSN data also showed that 15.1% of all the isolates belonged to Enterococcus spp.…”

“…The data from INICC also reveals a high degree of resistance in all the isolates [13,19]. Vancomycin resistant Enterococcus isolates were not observed in our study as compared to Tigen et al [16]. An increasing resistance to the antimicrobials is a worldwide concern which limits the therapeutic options and emphasizes the urgent need for implementation of strict hospital infection control measures.…”

Catheter associated urinary tract infection in an acute care setting of a tertiary care centre in South India

“…Other authors have found Candida species as one of the most frequently isolated organisms from CAUTI cases but according to CDC NHSN definition of UTI, Candida and other yeasts are excluded. 8,18,[25][26][27] Antimicrobial resistance amongst the uropathogens is an ever-increasing problem, especially in ICU setting. In the current study, multidrug resistance was observed in all isolates.…”

An Investigation of Antibacterial Resistance Patterns Among Acinetobacter baumannii and Pseudomonas aeruginosa Isolates Collected from Intensive Care Units of a University-Affiliated Hospital in Ahvaz, Iran

“…Infections in ICUs are a formidable healthcare concern (15), in particular the MDR A. baumannii and P. aeruginosa infections that have become increasingly common over the last few decades, especially among critically ill or immunocompromised patients (16). This resistance to common antibiotic agents may lead to outbreaks that can be very challenging for healthcare personnel to control.…”