Intensive Care Unit-Acquired Infections and Association of These Infections with Mortality: A Prospective Study in a Turkish Tertiary Care Hospital

Abstract

Objective: This study aimed to investigate epidemiological characteristics of infections and risk factors for mortality in intensive care unit (ICU) patients. Methods: A total of 164 patients hospitalized at Ankara Numune Education and Research Hospital in the medical and surgical ICU over 48 hours were included in the study over a period of nine months. The patients were followed prospectively until they died or were discharged from the ICU. Demographic characteristics of patients, underlying diseases, history of surgical operations, Acute Physiology and Chronic Health Evaluation II (APACHE II) score at admission, usage of invasive devices, nosocomial infections, isolated microorganisms, and outcome of cases were recorded on the standardized patient forms. Results: Of the patients, 96.3% (158) had at least one underlying disease, with neurological disorders being the most frequent. The mean length of stay in the ICU was 20.3 ± 18.7 days, while the APACHE II score at admission was 16.8 ± 7.3. During follow-up, 105 infection episodes occurred in 65 patients. Pneumonia (41.0%) was the most frequent infection. Acinetobacter baumannii was the most frequently isolated organism, and the most effective antimicrobials against these strains were colistin (97.3%) and tigecycline (83.0%). Rude mortality rate was estimated at 30.5% (50 patients). In multivariate logistic regression analysis, the APACHE II score was ≥15 at admission, surgical site infection acquired in the ICU and infection caused by A. baumannii were found to be independent risk factors for mortality (p 0.039, 0.040 and 0.025, respectively). Conclusion: Infections acquired in the ICU, especially those caused by A. baumannii, increase the mortality rate. Because A. baumannii is resistant to most antibiotics, treatment becomes very difficult. Early empirical treatment against A. baumannii may decrease the mortality rate in ICUs. J Microbiol Infect Dis 2016;6(2): 53-59  

Keywords

• Nosocomial infections,intensive care unit,mortality risk factors,A. baumannii

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