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Abstract

Introduction: Intensive care acquired nosocomial infections are one of the major causes of increased morbidity, mortality, and costs in intensive care units (ICU). Methods: After Institutional Review Board approval the charts of patients who were admitted to the surgical ICU at Baskent University between January 2009 and July 2012, were reviewed. Sixty patients who developed CR-BSI, VAP, or CA-UTI during their ICU stay were identified and they were compared to 53 appropriate matches who did not have any nosocomial infections. Results: Out of 103 patients who were included in the final analyses, 60 (58%) had a nosocomial infection. Twenty five (24%) out of 60 infected patients had CR-BSI, 46 (45%) had VAP, and 20 (19%) had CA-UTI. Higher APACHE II scores (OR: 1.142; 95% CI: 1.007-1.294; p=0.039), presence of a comorbidity (OR: 39.488; 95% CI: 2.075-750.950; p=0.014), prolonged hospitalization prior to ICU (OR: 1.155; 95% CI: 1.015-7.953; p=0.029), and use of sedatives (OR: 10.980; 95% CI: 1.167-103.337; p=0.036) during the ICU course were identified as the risk factors for nosocomial infections. Advanced age (OR: 1.037; 95% CI: 1.001-1.073; p=0.042) was found to be the risk factor for CR-BSI. Presence of diabetes mellitus (OR: 12.048; %95 CI: 1.157-125.000; p=0.037), immunosupression therapy (OR: 16.949, %95 CI: 2.463-111.111; p=0.004), and presence of a open wound (OR: 5.714; 95% CI: 1.017-37.258; p=0.048), higher APACHE II scores (OR: 1.132; 95% CI: 1.022-1.254; p=0.018), and prolonged duration of mechanical ventilation (OR: 1.084; 95% CI: 1.002-1.171; p=0.043) were determined as risk factors for VAP. Prolonged hospitalization prior to ICU (OR: 1.037; 95% CI: 1.004-1.072; p=0.027) was found to be the risk factor for CA-UTI. Conclusions: In conclusion, in a cohort of surgical ICU patients we found that a higher APACHE II score, longer length of hospital stay, use of sedatives, and the presence of comorbidities were the predictors of nosocomial infections. Additionally, the respective predictors of individual ICU infections including CR-BSI; VAP; and CR-UTI were advanced age; presence of immunosuppressive state, open wounds, and length of mechanical ventilation; and length of hospitalization.