Three-Year Evaluation of Nosocomial Infection Rates of the ICU

Dereli, Necla; Ozayar, Esra; Degerli, Semih; Şahin, Şaziye; Koç, Filiz

doi:10.1016/s0034-7094(13)70199-5

Cited by 28 publications

(22 citation statements)

References 9 publications

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“…The CLABSI incidence rate (7.7 per 1000 CL days) we observed was much lower than that reported from limited-resource countries [ 22 , 23 ], but higher than 1.1 per 1000 CL days reported in the medical/surgical major teaching ICUs in the healthcare facilities adhering to NHSN surveillance [ 19 ]. In the SPIN-UTI, in the 2010–2011 survey, and in the GiViTi projects the CLABSI incidence rate was 1.8 and 1.9 per 1000 CVC days, respectively [ 20 , 4 ].…”

Section: Discussioncontrasting

confidence: 74%

Prospective surveillance of healthcare-associated infections and patterns of antimicrobial resistance of pathogens in an Italian intensive care unit

Bianco

Capano

Mascaro

et al. 2018

Antimicrob Resist Infect Control

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BackgroundThe study aimed to evaluate the distribution of healthcare-associated infections (HAIs), the incidence rates and device utilization ratio (DUR) of device-associated infections (DAIs), as well as the distribution and patterns of antimicrobial resistance of the responsible pathogens.MethodsEligible patients who were admitted to an adult Intensive Care Unit (ICU) from May 1, 2013 to December 31, 2016 were included in the surveillance. Demographics, intrinsic and extrinsic risk factors, information regarding infection and isolated pathogens with antibiogram results were collected.ResultsOne thousand two hundred eighty-three patients were included in the surveillance. One hundred forty-seven HAIs were detected with a cumulative incidence of 9.2 per 100 patients 4-year period and an incidence rate of 17.4 per 1000 patient days. Fifty-six out of 1283 patients were affected by at least one episode of ICU-acquired pneumonia, and 72.7% of these were associated with intubation. ICU-acquired bloodstream infections (BSIs) occurred in 4.4% of patients and 89.5% were catheter-related. ICU-acquired urinary tract infections (UTIs) occurred in 1% of patients, with 84.6% of the episodes being associated with the use of an urinary catheter. The pattern of antimicrobial-resistance in the isolates showed, among the Gram-positive bacteria, that 66.6% and 16.6% of Staphylococcus epidermidis were oxacillin and teicoplanin resistant, respectively. Among the Gram-negative bacteria, carbapenem resistance was found in 91.6% of Acinetobacter baumannii and 28.5% of Klebsiella pneumoniae isolates.ConclusionsThe majority of HAIs in the ICU studied were associated with the use of invasive devices. Since a significant proportion of these HAIs are considered preventable, reinforcement of the evidence-based preventive procedures are needed.Electronic supplementary materialThe online version of this article (10.1186/s13756-018-0337-x) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 74%

Prospective surveillance of healthcare-associated infections and patterns of antimicrobial resistance of pathogens in an Italian intensive care unit

Bianco

Capano

Mascaro

et al. 2018

Antimicrob Resist Infect Control

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“…In our ICU, BSI occupied the first place (33.90%), followed by respiratory diseases (33.22%), abdominal infections (9.89%) and urinary tract infections (8.70%). The predominance of BSI is also to be found in other studies, like in a Greek study, where the infection distribution was: 36.1% BSI, 25.3% ventilator associated pneumonia, 18.7% surgical infections, 10.4% infections associated with vascular catheter and 9.5% urinary tract infections [ 17 , 18 ].…”

Section: Discussionsupporting

confidence: 72%

Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit

et al. 2017

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BackgroundDue to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies.MethodsBetween 1st January 2012 and 31st December 2013, a prospective study was conducted in the largest ICU of Western Romania. The study group was divided into four sub-samples: patients who only received prophylactic antibiotherapy, those with community-acquired infections, patients who developed hospital acquired infections and patients with community acquired infections complicated by hospital-acquired infections. The statistical analysis was performed using the EpiInfo version 3.5.4 and SPSS version 20.ResultsA total of 1596 subjects were enrolled in the study and the recorded consumption of antimicrobial agents was 1172.40 DDD/ 1000 patient-days.The presence of hospital acquired infections doubled the length of stay (6.70 days for patients with community-acquired infections versus 16.06/14.08 days for those with hospital-acquired infections), the number of antimicrobial treatment days (5.47 in sub-sample II versus 11.18/12.13 in sub-samples III/IV) and they increased by 4 times compared to uninfected patients. The perioperative prophylactic antibiotic treatment had an average length duration of 2.78 while the empirical antimicrobial therapy was 3.96 days in sample II and 4.75/4.85 days for the patients with hospital-acquired infections. The incidence density of resistant strains was 8.27/1000 patient-days for methicilin resistant Staphylococcus aureus, 7.88 for extended spectrum β-lactamase producing Klebsiella pneumoniae and 4.68/1000 patient-days for multidrug resistant Acinetobacter baumannii. ConclusionsSome of the most important circumstances collectively contributing to increasing the consumption of antimicrobials and high incidence densities of multidrug-resistant bacteria in the studied ICU, are represented by prolonged chemoprophylaxis and empirical treatment and also by not applying the definitive antimicrobial therapy, especially in patients with favourable evolution under empirical antibiotic treatment. The present data should represent convincing evidence for policy changes in the antibiotic therapy.

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“…There has been reported an increase in patients with cancer during the last decade [ 18 ]. Some studies have reported a wide variation rate between 5.3 and 56.1 % [ 19 ]. Our HAI rate was 40.7 %.…”

Section: Discussionmentioning

confidence: 99%

Hospital-acquired infections at an oncological intensive care cancer unit: differences between solid and hematological cancer patients

et al. 2016

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BackgroundCancer patients have a higher risk of severe sepsis in comparison with non-cancer patients, with an increased risk for hospital-acquired infections (HAI), particularly with multidrug resistant bacteria (MDRB). The aim of the study is to describe the frequency and characteristics of HAI and MDRB in critically ill cancer patients.MethodsWe conducted an 18-month prospective study in patients admitted ≥48 h to an ICU at a cancer referral center in Mexico. Patients with hematological malignancies (HM) were compared with solid tumors. Demographic and clinical data were recorded. Mortality was evaluated at 30-days.ResultsThere were 351 admissions during the study period, among whom 157 (66 %) met the inclusion criteria of the study as follows: 104 patients with solid tumors and 53 with HM. Sixty-four patients (40.7 %) developed 95 episodes of HAI. HAI rate was 4.6/100 patients-days. MDRB were isolated in 38 patients (24 %), with no differences between both groups. Escherichia coli was the main bacteria isolated (n = 24), 78 % were extended spectrum beta-lactamases producers. The only risk factor associated with HAI was the presence of mechanical ventilation for more than 5 days (OR 3.12, 95 % CI 1.6 – 6.2, p = 0.001). At 30-day follow-up, 61 patients (39 %) have died (38 % with solid tumors and 60 % with HM, p < 0.001). No differences were found in mortality at 30-day between patients with HAI (n = 25, 39 %) vs. non-HAI (n = 36, 38.7 %, p = 0.964); neither in those who developed a HAI with MDRB (n = 12, 35.3 %) vs. HAI with non-MDRB (n = 13, 43.3 %, p = 0.51).ConclusionsPatients with cancer who are admitted to an ICU, have a high risk of HAI, but there were no differences patients with solid or hematologic malignancies.

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Three-Year Evaluation of Nosocomial Infection Rates of the ICU

Cited by 28 publications

References 9 publications

Prospective surveillance of healthcare-associated infections and patterns of antimicrobial resistance of pathogens in an Italian intensive care unit

Prospective surveillance of healthcare-associated infections and patterns of antimicrobial resistance of pathogens in an Italian intensive care unit

Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit

Hospital-acquired infections at an oncological intensive care cancer unit: differences between solid and hematological cancer patients

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