Risk factors of hospital-acquired infections in a neurology-neurosurgery intensive care unit, in a tertiary care hospital, in Turkey
Abstract number: P1122
Bulut C., Yetkin M.A., Ataman Hatipoglu C., Yilmaz G.R., Erdinc F., Yildiz E., Karakoc E., Demiröz 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 May 2007. 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: Two hundred and fiftyfour ICU-acquired infections occurred in 160 (36.1%) of 443 patients during 5224 patient-days. The overall rate of ICU-acquired infection was 57.3/100 patients and 48.2/1000 patient-days. The most common site-specific infections were urinary tract infections (38.5%), pneumonia (31.7%), and bloodstream infections (22.9%). Urinary catheter-associated urinary tract infection rate was 23.7/1000 urinary catheter-days; central line-associated bloodstream infection rate was 37.9/1000 central line-days and ventilator-associated pneumonia rate was 31.6/1000 ventilator-days. The utilisation ratios of urinary catheter, central line catheter and ventilator were 0.90, 0.39 and 0.34, respectively.
In univariate analysis, age >60 years, being a neurology patient, presence of nasogastric tube, central venous catheter and arterial catheter, mechanical ventilation 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 < 0.01), presence of central venous catheter (p < 0.01), mechanical ventilation (p < 0.1) and parenteral nutrition (p > 0.05) as independent risk factors.
Conclusion: In this study, ICU-acquired infection rates were found higher when compared with NNIS results. In interpretation of device-associated infection rates, those high rates made us to take immediate precautions both for decreasing device utilisation and emphasising the importance of device application and care practices.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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