Abstract PR091

Abstract

Background & Objectives: The incidence of nosocomial infections in patients in ICUs is estimated to be 5 to 10 times more than patients in non-critical care areas, contributing to a higher mortality and morbidity among the ICU patients (1).Infections acquired in the ICU due to invasive interventions or otherwise, have a high degree of virulence and cause significant mortality and morbidity. The objectives of this study were to assess epidemiology of blood stream and catheter related bacterial infections, the effect of these infections on the ICU stay duration,mechanical ventilation duration and mortality and to identify potential risk factors for ICU-acquired bacterial infection and death in a cohort of ICU patients. Materials & Methods: An observational, retrospective study was conducted on a cohort of ICU patients. Patients whose ICU-length of stay was longer than 48 h were considered eligible for our study.’ICU-acquired infections’ were defined as those acquired more than 48 h after ICU admission. The incidence of ICU-acquired infections was described as percentage. Patients who presented with an ICU-acquired infection (the study group) were compared to remaining patients (the control group). The results of continuous variables were presented as a mean ± SD. Categorical variables were analysed using the chi-square test and presented as a percentage. Logistic regression analysis was performed to identify risk factors of ICU-acquired infections and mortality. Results of multivariate analysis were presented as a p-value and odds ratio with 95 % confidence interval. Data were analysed using the STATA 9.1 software. Results: Of the 153 patients enrolled in our study, 57% had proven ICU acquired bacterial infection. The most common bacteria responsible for the ICU acquired infections were K.pneumoniae (49% of ICU-acquired infections) and E.coli (40%). Most frequent types of ICU infection reported were the respiratory tract infection (50%), followed by urinary tract infection (43 %), non-catheter-related bacteraemia (12 %) and central venous catheter related infections (6 %). The ICU-length of stay and duration of mechanical ventilation were higher in the study group than in the control group (p < 0.001).Significantly higher mortality was seen in the control group(p=0.006). Four risk factors were independently associated with proven ICU acquired bacterial infections: duration of intubation, indwelling urethral catheter duration,mechanical ventilation duration and ICU stay duration. Conclusion: In our cohort of patients, proven ICU acquired bacterial infections were common (57% of all patients), but presence of proven bacterial infection was not found to be a predictor of mortality.