Evaluation of hospital acquired infections in the tertiary intensive care unit: a three-year analysis

Yıl 2022, Cilt: 5 Sayı: 1, 321 - 325, 17.01.2022

Fatma Yılmaz Aydın , Emre Aydın

https://doi.org/10.32322/jhsm.1037607

Cited By: 1

Öz

Introduction: Hospital-acquired infections (HAI) occurring in intensive care units (ICUs) are an important risk factor for mortality and morbidity. In some patient groups followed in ICUs, the risk of developing nosocomial infections increases even more. Especially, patients with end-stage renal disease (ESRD) carry a serious risk for HAI when they are hospitalized in ICUs. Our aim is to determine the rate and incidence of hospital infection, the distribution of infections and the most common microorganisms in our ICU, to initiate appropriate empirical treatment and to prevent the development of antibiotic resistance.
Material and Method: A total 158 patients with a diagnosis of hospital-acquired infection hospitalized between January 2017 and December 2019 at general internal medicine intensive care unit, were included in this study. The clinical findings, culture results and laboratory data of the patients were recorded. According to years, the HAI rate, density and infection agents in the ICU were determined.
Results: 158 episodes of nosocomial infections were detected in 128 of 556 patients who were hospitalized within three years. The hospitalization day was 9048, and the three-year ICU HAI rate was calculated as 29.19%. HAI density was 17.45 in 1000 patient days. Bloodstream infection was the most common (30.38%), followed by ventilator-associated pneumonia (28.48%) and catheter-related urinary tract infection (24.68%). Gram-negative microorganisms were the most common infectious agents. Among the Gram-negative bacteria, the most frequently isolated bacteria were A. baumannii, K. pneumoniae and P. aeruginosa. Among Gram-positive bacteria, Enterococcus spp. was most frequently isolated
Conclusion: The risk of HAI is high in patients hospitalized in ICUs. In order to control nosocomial infections, HAI incidences and rates should be evaluated, infectious agents, and prospective effective infection control strategies should be developed by taking necessary precautions according to surveillance results. These measures will significantly reduce the incidence of HAI.

Anahtar Kelimeler

Intensive Care Unit, Hospital Infections, Hospital-Acquired Infection Rate, Infectious Agents, Central Venous Catheter

Kaynakça

• Bilge N, Yevgi R, Ceylan M, Parlak E, Şimşek F. Nosocomial infection rates of three-years in neurological intensive care unit and relationship to mortality. Anatolian Curr Med J 2021; 3; 158-64.
• Mitharwal SM, Yaddanapudi S, Bhardwaj N, Gautam V, Biswal M, Yaddanapudi L. Intensive care unit-acquired infections in a tertiary care hospital: An epidemiologic survey and influence on patient outcomes. Am J Infect Control 2016; 44: e113-7.
• Samlıoglu P and. Atalay S. Five-year analysis of central nervous system, blood and nosocomial infection factors associated with central venous catheter in adult and pediatric intensive care units. J Biotechnol and Strategic Health Res 2021; 5: 119-124.
• D'Agata EM, Mount DB, Thayer V, Schaffner W. Hospital-acquired infections among chronic hemodialysis patients. Am J Kidney Dis 2000; 35: 1083-8.
• 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: 309-32.
• Tüfek A, Tekin R, Dal T, et al. Evaluation of hospital infections developing in intensive care unit during a decade and review of literatüre. Dicle Med J 2012; 39: 492-8.
• Vincent JL, Sakr Y, Singer M, et al. Prevalence and outcomes of infection among patients in intensive care units in 2017. JAMA. 2020; 323: 1478-87.
• Taş SS and Kahveci K. Surveillance of hospital infections in long-term intensive care unit and palliative care centre: a 3-year analysis. J Contemp Med 2018; 8: 55-9.
• Senol A, Balin SÖ. Common infections in intensive care units, gram-negative microorganisms, antibiotic resistance. KSU Med J 2021; 16: 35-9.
• Sahin AR, Yıldız BT, Aktemur A, Topal B, Nazik S, Ateş S. Evaluation of nosocomial infections in a neurological intensive care unit of a university hospital. J Contemp Med 2019; 9: 43-7.
• Cetin S, Celik I, Artan C. Evaluation of microorganisms and antibiotic resistance profile isolated in intensive care unit patients. Turk J Intensive Care 2021; 19: 9-17.
• Ulusal Sağlık Hizmeti, İlişkili Enfeksiyonlar Sürveyans Ağı (USHIESA) Haziran 2021.https://hsgm.saglik.gov.tr.
• Koçer I, Zer Y, Karaoglan I. The clinic significance of urinary culture results for catheter- related urinary tract infection. Bozok Med J 2020; 10: 62-6.
• Abbasi SH, Aftab RA, Chua SS. Risk factors associated with nosocomial infections among end stage renal disease patients undergoing hemodialysis: a systematic review. PLoS ONE 2020; 15: e0234376.
• Tang LY, Chen JG. Economic impact of nosocomial infection in hemodialysis patients. Acta Medica Mediterranea 2016, 32: 617.
• Ulusal Sağlık Hizmeti, İlişkili Enfeksiyonlar Sürveyans Ağı (USHIESA) Etken Dağılımı ve Antibiyotik Direnç Raporu 2020. Haziran 2021. https://hsgm.saglik.gov.tr.