Incidence and Pathogen Distribution of Healthcare-Associated Infections in Pilot Hospitals in Egypt

Abstract

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.

Cost analysis and evaluation of nosocomial infections in intensive care units

“…The most commonly encountered microorganisms in a study from Italy were A. baumannii (61.9%), P. aeruginosa (22.5%), E. faecalis (4.2%), and C. albicans (4.2%) (18). The most common microorganisms in a study from Egypt were Acinetobacter species (21.8%) and Klebsiella species (18.4%), and all Acinetobacter strains were multidrugresistant (19). The most common agents in our study were A. baumannii, P. aeruginosa, and S. aureus.…”

National surveillance of health care–associated infections in Egypt: Developing a sustainable program in a resource-limited country

“…17 The methods implemented and the results of phase 1 surveillance have been previously published. 18 …”

“…Finally, HAI types were not restricted to DAIs given that 58% of BSIs were not central line associated and a large proportion of pneumonias were also not ventilator associated. 18 Phase 1 surveillance was conducted from April 2012-August 2014. The 11 hospitals that started phase 1 surveillance transitioned into phase 2, and an additional 17 hospitals joined the program for a total 28 hospitals, 91 ICUs, and 989 ICU beds in phase 2 surveillance.…”

“…18 In brief, personal digital assistants (PDAs) were used since the beginning of the surveillance program in April 2011 to facilitate data entry. The PDAs were programmed using a decision-based tree to help with classifications of HAIs based on surveillance definitions.…”

Milestones along the road of infection prevention in Egypt

“…With the advent of the global problem of rapid increase of multidrug resistant gram negatives, especially Carbapenemase producing Enterobacteriacae (CRE), different hospitals in Egypt are experiencing a steady increase in infections caused by these pathogens [36]. Within Acinetobacter species, isolates causing HAI from different cancer hospitals >70 % carbapenem resistance was encountered.…”