Backround: Hospital-acquired infections (HAIs) are issues for not only patients who get treatment in the intensive care unit but also for patients who are being treated in internal medicine and surgical departments. HAIs cause functional disorders, less life quality or even death. The aim of this study was to investigate the prevalence of HAIs, distribution of the infections, and isolated microorganisms in units other than the intensive care units (ICU).

Materials and Methods: Data of the patients who developed hospital infections between January 2014 and December 2017 were evaluated retrospectively. The McCabe score was used for categorical evaluation.

Results: The overall HAI rate was 0.17%. Of these, 619 (53.1%) occurred in departments other than the intensive care units. The most common HAI was surgical site infection (n: 223, 36%) followed by urinary tract infection (n: 176, 28.4%) and pneumonia (n: 125, 20.2%). According to patients' comorbid disease status, 48% (n: 297) was McCabe class 1, 30% (n: 186) was McCabe class 2, and 22% (n:136) was McCabe is class 3. In 85 (13.7%) of 619 HAI cases, the agent could not be isolated, and the diagnosis of HAI was based on clinical findings. Four-hundred-ninety-two bacteria were isolated and 409 (83.1%) were gram-negative whereas 83 (16.9%) were gram-positive.

Conclusions: HAIs are important health problems not only for patients in intensive care units, but also for patients who are treated in services. It was thought that the characteristics of the concomitant diseases need to be taken into consideration in preventing hospital infections.

• References1.Alp E, Leblebicioglu H, Doganay M, Voss A. Infection control practice in conutries with limited resources. Ann ClinMicrobiolAntimicrob. 2011;10:36.2.Vincent JL, Rello J, Marshall J, et al.International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009; 302(21):2323–29.3.Emori TG, Culver DH, Horan TC, Jarvis WR, White JW, Olson DR et al. National nosocomial infections surveillance system (NNIS): description of surveillance methods. Am J Infect Control. 1991;19(1):19-35.4.Öztürk R. Recent Developments related to Infection Control in Turkey. ANKEM Derg.2011;25(Ek 2):9-16.Available from: https://www.ankemdernegi.org.tr/ANKEMJOURNALPDF/ANKEM_25_Ek2_0_0.pdf5.TC Sayıştay Bakanlığı Performans Denetimi Raporu. Hastane enfeksiyonları ile mücadele. Erişim: http://www.hider.org.tr/Yeniden/2007-2hastaneenfeksiyon.Pdf6.Turkish Republic Health Instution Department of Infectious Diseases. Agent distribution and antibiotic resistance surveillance report for national healthcare-associated infections 2017. Available from: https://infline.saglik.gov.tr/7.Reilly JS, Coignard B, Price L, Godwin J, Cairns S, Hopkins S et al.The reliability of the McCabe score as a marker of co-morbidity in healthcare associated infection point prevalence studies. J Infect Prev. 2016;17(3):127-9.8.Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008; 36(5):309-32.9.Clinical and Laboratory Standards Institute (2013) Performance Standards for Antimicrobial Susceptibility Testing, Twenty-Third Informational Supplement. Avaliable at: https://clsi.org/media/2663/m100ed29_sample.pdf 10.Dereli N, Ozayar E, Degerli S, Sahin S, Koç F. Three-year evaluation of nosocomial infection rates of the ICU. Braz J Anesthesiol. 2013;63(1):73-811.Erdem H, Inan A, Altındis S, Carevic B, Askarian M, Cottle L, et al. Surveillance, control and management of infections in intensive care units in Southern Europe, Turkey and Iran--a prospective multicenter point prevalence study. J Infect. 2014;68(2):131-40.12.Erdem H, Dizbay M, Karabey S, Kaya S, Demirdal T, Koksal I, et al. Withdrawal of Staphylocoocus aureus from intensive care units in Turkey. Am J Infect Control. 2013;41(11):1053-8.13.Tukenmez Tigen E, Dogru A, Koltka EN, Unlu C, Gura M. Device-associated nosocomial infection rates and distribution of antimicrobial resistance in a medical-surgical intensive care unit in Turkey. Jpn J Infect Dis. 2014;67(1):5-8.14.Ellidokuz H, Uçku R, Uysal U, Abacioğlu H. Hospital-aquired infections in elderly patients: results of a West Anatolian University Hospital survellance. Arch Gerontol Geriatr. 2003;37(3):259-63.15.Metintas S, Akgun Y, Durmaz G, Kalyoncu C. Prevalance and characteristics in a Turkish university hospital. Am J Infect Control. 2004;32(7):40-1.16.Wright SB, Ostrowsky B, Fishman N, Deloney VM, Mermel L, Perl TM. Expanding roles of healthcare epidemiology and infection control in spite of limited resources and compensation. Infect Control Hosp Epidemiol. 2010;31(2):127-3217.Samuel SO, Kayode OO, Musa OI, Nwigwe GC, Aboderin AO. Nosocomial infections and the challenges of control in developing countries. Afr J Cln Exper Microbiol. 2010;11(2): 102-110.18.Lyytikäinen O, Kanerva M, Agthe N, Möttönen T, Ruutu P; Finnish Prevalence Survey Study Group. Healthcare-associated infections in Finnish acute care hospitals: a national prevalence survey, 2005. J Hosp Infect. 2008;69(3): 288-94.19.Çelebi G, Pişkin N, Aydemir H, Öztoprak N, Külah C, Demiroğlu Y. Nosocomial Infections Surveillance in Zonguldak Karaelmas University Hospital. Hastane Infeksiyonları Derg. 2006;10:82-190.20.Karahocagil MK, Yaman G, Göktaş U, Sünnetçioğlu M, Çıkman A, Bilici A, ve ark. Hastane enfeksiyon etkenlerinin ve direnç profillerinin belirlenmesi. Van Tıp Derg. 2011;18 (1):27–32. 21.Saçar S, Kavas ST, Asan A, Cevahir N, Serin S, Turgut H. Surveillance of nosocomial infections in Pamukkale University Hospital: 3-year analysis. İnfeksiyon Derg. 2008; 22 (1):15-21.22.ECDC. Point prevalence survey of healthcare associated infections and antimicrobial use in European acute care hospitals. Available from: http://www.nsih.be/download/ECDC%20PPS/ECDC_PPSII_HAI_AU_Protocol.pdf.