Device-associated infection rates in different intensive care units in a tertiary care hospital in Egypt

Abstract

Abstract Background: Device-associated hospital-acquired infections (DA-HAIs) are a threat to patient safety, particularly in the intensive care units (ICUs). Methods: A prospective observational study was carried out for 12 months from January 2017 to December 2017 in five ICUs including General intensive care unit (General ICU), Cardiology care unit (CCU), Neonatal intensive care unit (NICU), Pediatric intensive care unit (PICU), and Neurosurgery intensive care unit (Neurosurgery ICU) of Mansoura New General Hospital (MNGH). Data were collected from patient's file and laboratory results according to definitions of CDC. DA-HAIs were calculated by dividing the total number of device associated infections (DAIs) by the total number of device days and multiplying the result by 1,000. Results: In the current study 1,666 patients hospitalized for 11.280 days in the different ICUs. These patients acquired 91 DA-HAIs. The most frequent DA-HAIs (per 1000 device-days) were Ventilator-associated Pneumonia (VAP) (10.9), central line-associated blood stream infection, (CLA-BSI) (5.9), and catheter-associated urinary tract infections (CA-UTI) (5.6). The urinary catheter utilization ratio was 0.54, central line utilization ratio was 0.33, and ventilator utilization ratis was 0.28. The most frequently isolated organisms were Klebsiella spp. (34%) and E.coli (20.9%). The most frequent bacteria causing VAP, CLA-BSI, and CA-UTI were Klebsiella spp. (60%), Staphylococcus aureus and Enterococcus spp (27.3% for each)., and E.coli (41.2%) respectively.. Conclusion: Surveillance of DA-HAIs is the first step to improve infection control activity and to implement preventive bundles measures in the intensive care unit.