Risk factors of hospital-acquired infections in a neurology-neurosurgery intensive care unit in a tertiary care hospital, Turkey
Abstract number: 1734_166
Bulut C., Yilmaz G.R., Yetkin M.A., Erdinc F.S., Ataman Hatipoglu C., Yildiz E., Karakoc E.A., Demiroz A.P.
Objectives: Intensive care unit (ICU)-acquired infections are associated with high mortality, excessive length of ICU and hospital stay, and high hospital costs. The risk factors for nosocomial infections may differ according to the type of ICU. The aim of this study was to evaluate the risk factors for ICU-acquired infections in the patients treated in neurology-neurosurgery ICU.
Method: The study was conducted in Ankara Training and Research Hospital, from May 2006 to November 2006. The patients treated for more than 48 hours in 14-bed neurology-neurosurgery ICU were enrolled into the study. The patients were followed until death or three days after discharge by prospective daily surveillance. Nosocomial infections were identified according to CDC criterias. Risk factors for ICU-acquired infections were analysed with a logistic regression model.
Results: Seventy-one ICU-acquired infections occurred in 52 (30.4%) of 171 patients during 1440 patient-days. The overall rate of ICU-acquired infection was 37.4/100 patients and 44.4/1000 patient-days. The most common site-specific infections were pneumonia (36.0%), urinary tract infections (31.3%), and bloodstream infections (24.0%). Urinary catheter-associated urinary tract infection rate was 15.0/1000 urinary catheter-days; central line-associated bloodstream infection rate was 23.7/1000 central line-days and ventilator-associated pneumonia rate was 40.6/1000 ventilator-days. The utilisation ratios of urinary catheter, central line catheter and ventilator were 0.92, 0.38 and 0.19, respectively. In univariate analysis, age ``d60 years, glasgow coma scale score'' T10, being a neurology patient, presence of nasogastric tube, central venous catheter, heart failure, and the presence of two or more underlying diseases were determined as significant risk factors for ICU-acquired infections (p < 0.05). Multi-variate logistic regression analysis revealed, being a neurology patient (p < 0.01), presence of nasogastric tube (p < 0.05), and presence of central venous catheter (p < 0.01) as independent risk factors.
Conclusion: In that study, ICU-acquired infection rates were found higher when compared with NNIS results. In interpretation of device-associated infection rates, the rates of device-use should be known those high rates made us to take immediate precautions both for decreasing device utilisation and emphasizing the importance of device application and care practices.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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