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Risk factors for nosomial infections in an intensive care unit

Abstract number: R2447

Murcia-Payá J., García-Vázquez E., Canteras M., del Rey Carrión M.D., Alonso Fernández N., Galindo Martínez M., Díaz-Pastor A., Rodríguez-Mulero M.D., Melgarejo-Moreno A., Gómez-Gómez J., Allegue J.M.

Objectives: Knowledge on risk factors (RF) for the development of nosocomial infection (NI) is crucial to establish preventive measures; our aim is to assess RF for NI in an Intensive Care Unit (ICU) at a second level hospital.

Patients and Methods: A prospective and observational study of NI cases on the ICU during a 12 month period; epidemiological and clinical variables as well as information about risk factors related to NI were assessed (underlying conditions, severity at admission, rate of urgent surgeries, invasive techniques, ICU length of stay, mechanical ventilation, etc.). A logistic regression statistical analysis was done to identify RF for different groups of NI.

Results: 806 patients were assess during the study period (33% women; mean age 66.4±14.86 years). Mean ICU length of stay was 4.6±6.72 days. Mean APACHE II score was 11.41±8.25. Reasons for ICU admission were: coronary disease 65%, other medical reasons 27%, surgical patients 5% and traumatisms 2%; 40% of patients required central intravenous line (CIL), 20% mechanical ventilation (MV), 48% urinary catheter, 18% surgery and 5% urgent surgery. In the statistical logistic analysis RF associated to NI were: a) for nosocomial pneumonia, APACHE II >15 (OR = 6.17; CI 95%, 1.39–27.33), MV duration >5 days (OR = 9.98; CI 95%, 1.81–55.04) and tracheotomy during more than 2 days (OR = 14.73; CI 95%, 3.13–69.27); b) for urinary infection, urinary catheter duration >3 days (OR = 4.03; CI 95%, 1.60–10.18) and ICU admission >10 days (OR = 3.55; CI 95%, 1.41–8.91); c) for catheter related bacteraemia, neutropenia (OR = 5.46; CI 95%, 1.33–22.39) and CIL duration >6 days (OR = 35.89; CI 95%, 16.31–79) and d) for surgical site infection, surgical re-intervention (OR = 42.61; CI 95%, 3.25–558.64), urgent surgical re-intervention (OR = 30.89; CI 95%, 4.31–221.39) and ICU admission >10 days (OR = 4.94; CI 95%, 1.19–20.47).

Conclusions: Mean RF for NI were identified in our cohort and were related to severity at admission, invasive techniques (urinary catheter, CIL and MV) and ICU length of stay. Knowledge on these RF for NI is crucial to establish preventive measures mainly in terms of the care associated to invasive techniques.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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