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

Year 2016, Volume: 6 Issue: 2 - J Microbiol Infect Dis 2016; 06(02) June Issue, 53 - 59, 01.06.2016

Bircan Kayaaslan Ayse But

https://doi.org/10.5799/jmid.328800

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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