Nosocomial Infections In ICU Research Articles

FAKTOR YANG MEMENGARUHI MORTALITAS PASIEN RAWAT INAP DI RUMAH SAKIT AKADEMIK UGM

Background: Hospital mortality indicators are an important element of a hospital patient safety monitoring program. In 2022, the record of inpatient performance at Academic Hospital UGM (RSA UGM) shows that the Net Death Rate (NDR) value has not yet reached the ideal standard, namely 34.1‰.
 Objective: Identifying factors that influence the mortality rate of adult patients ≥48 hours in inpatient care and developing a program plan to reduce hospital mortality at RSA UGM.
 Methods: An explanatory sequential design of mixed methods research was used. The medical records of adult patients admitted to RSA UGM from October 2022 to December 2022. Quantitative data analysis used chi-square, Fisher’s exact tests, and multivariate logistic regression. Qualitative data was obtained from focus group discussions with three separate groups, namely the managerial group, the doctor team, and the nurse team., while qualitative data used thematic analysis.
 Results: 388 subjects were obtained with 18 (4.64% or 46.4‰) patients who died during treatment ≥48 hours. Independently, ward type (OR 10,799, CI 95 % 3,990 – 29,233), EWS score (OR 15,644, CI 95 % 5,511 – 44,412), and some comorbidities (OR 8,603, CI 95 % 2,769 – 26,730) associated with ≥48 hours in-hospital mortality (<0.001). Multivariate analysis showed that ward type (p=0.018, aOR 4,122, CI 95 % 1,279 – 13,284) and Early Warning System (EWS) score (p=0.016, aOR 4,531, CI 95 % 1,327 – 15,469) had a strong association with ≥48 hours in-hospital mortality. The proposed program to reduce hospital mortality rates by increasing ICU capacity, improving the competency and skills of ICU nurses, adding intensivists, controlling nosocomial infections in ICU, increasing understanding regarding EWS for ward nurses, improving the EWS monitoring, and improving the competency of ward nurses in emergencies condition.
 Conclusion: The EWS score >5 and intensive care are significantly related to in-hospital mortality ≥48 hours after hospitalization so management needs to improve the quality of services at the RSA UGM by carrying out a strategy to reduce hospital mortality rates to decrease the net mortality rate in accordance with the Ministry of Health’s national standards.

Nosocomial infections and antimicrobial susceptibility patterns among patients admitted to intensive care unitofImam Khomeinihospitalin Ilam, Iran.

Nosocomial infections (NIs) are a major challenge worldwide. Identification of antibiotic resistance pattern extended spectrum beta-lactamases (ESBLs) and carbapenem-resistant Enterobacteriaceae (CRE) were the objectives of this study. In this cross-sectional study, the antimicrobial susceptibility pattern of bacterial isolates collected from patients with NIs in ICU was determined. Overall, 42 Escherichia coli and Klebsiella pneumoniae isolates from different infection sites were used to determine phenotypic tests of ESBLs, Metallo-β-lactamases (MBLs) and CRE. Detection of ESBLs, MBLs and CRE genes were performed by the polymerase chain reaction (PCR) method. From 71 patients with NIs, 103 different bacterial strains were isolated. The most frequently isolated bacteria were E. coli (n = 29; 28.16%), Acinetobacter baumannii (n = 15; 14.56%), and K. pneumoniae (n = 13; 12.26%). Also, the rate of multidrug-resistant (MDR) isolates was 58.25% (60/103). Based on phenotypic confirmation tests, 32 (76.19%) isolates of E. coli and K. pneumoniae produced ESBLs, and 6 (14.28%) isolates were identified as CRE producers. PCR showed the high prevalence of the blaCTX-M (n = 29; 90.62%) in ESBL genes. In addition, blaNDM was detected in 4 (66.66%), blaOXA-23 in 3 (50%), and blaOXA-48 gene in 1 (16.66%) isolates. The blaVIM, blaKPC, and blaIMP genes were not detected in any of the isolates. The Gram-negative bacteria E. coli, A. baumannii, and K. pneumoniae with high resistance levels were the most common bacteria causing NIs in the ICU. This study for the first time identified blaOXA-11, blaOXA-23, and blaNDM-1 genes in E. coli and K. pneumoniae in Ilam city of Iran.

Evidence-Based Practices of Nurses Regarding Nosocomial Infection in ICU. A Descriptive study

Nosocomial infections influence patients’ lives over lengthy hospitalization, illness, and death, following important costs to both health organizations and society. Evidence-based practice is observed as a system to carry out health care that is additionally effective and important in the current health care setting. Objective: To identify the level of evidence-based practices of nurses regarding nosocomial infection in the intensive care units. Methods: A cross-sectional descriptive study design was used. The population was the ICU staff nurses of the Tertiary Care Hospital, Lahore. The duration of the study with 09 months after the synopsis approval. The sample size of 72 nurses has calculated a population size 95 confidence interval and a margin of error of 5%. A convenient sampling Technique was used in this study. The questionnaire was consisting of 4 items and 31 questions. Ethical Considerations were maintained. Data were kept confidential and secure by coding. Data were analyzed by SPSS version 21. Results: The highest percentage of staff nurses in this study were females (98.6%) and aged between 26-35 years (76.4%) and diploma holder were (69.4%). Nurses who have experience less than 10 years were 45.8%. Most of the participants were performing hand hygiene practicing frequently (59.7%) whereas (16.7%) were performing rarely before contact with patient. Highest percentage of participants (77.8%) were using personal protective equipment’s. Conclusions: Evidence-Based Knowledge related to nosocomial infection is adequate among nurses. Hand hygiene performance is adequate as compared to international standards.

Nosocomial infections in surgical intensive care unit

Background: Various microorganisms predominant in hospitals causes nosocomial infections (NIs) making patients in Surgical intensive care units (SICU) prone to NI. Aim: To study the prevalence, antibiotic and microbiological sensitivity, and resistance profiles, as well as the influence of NI in ICU, stay and mortality in patients admitted to our hospital's SICU. Materials and Methods:Over a period of a year, a retrospective investigation of all surgical ICU patients was performed. All patients who suffered withNIwere included in the study. The incidence of NI, their sites, and the bacteria that cause them have all been recognized. The grown bacteria's antibiotic sensitivity pattern was discovered. By comparing this group of patients with NIto a group of patients without NI in terms of age, gender, and clinical diagnosis, the impact of NIon ICU duration and death was assessed. Results:During the trial, 80 of the 235 patients who were admitted to ICU developed NIand were selected. The control group consisted of 80 patients who matched the research group's participants. In our research, 34.04% of patients had NI. The most prevalent nosocomial infection was skin and soft tissue infections (37.89%), which included surgical wound infections, followed by respiratory infections (24.21%) and genitourinary infections (22.11%).

Specific and non-specific prevention of nosocomial infections in ICU of Burn Centre and their place in multimodal control system

The aim of the study is to evaluate the effectiveness of a number of technologies for controlling purulent-septic infections in a multi-modal system for the prevention of ICP in the ICU of a burn center. Materials and methods . Research on the basis of the ICU of burn center of City Clinical Hospital No. 40 (Yekaterinburg, Russia). To evaluate the effectiveness of the Pseudovac vaccine, a single-center, pilot, prospective, randomized, and parallel study was performed. The observation group consisted of 48 patients, of which 24 patients were included in the experimental group, and 24 – in the control group. The effectiveness was evaluated based on the frequency of hospital infections and colonization caused by P. aeruginosa. We also evaluated the characteristics of antimicrobial therapy with an assessment of the duration of antimicrobial therapy, the number of days free from antibiotic therapy, and the consumption of antibiotics. In order to evaluate the effectiveness of using detergents with probiotic effect and aerosol high-dispersion aerosol of the air-cleaning agent, the number of positive seeding of microorganisms, including pathogens with altered biochemical characteristics before and after treatment of air and hospital environment objects was analyzed. The McNemar test was used to compare relative indicators that characterize related populations. Results and discussions . In the group of unvaccinated patients, there were more hospital infections (83.0 %) than in the experimental group (70.8 %), p = 0.4936. Patients in the control group were infected and colonized with P. aeruginosa strains – 62.5 %, while in the experimental group there were 37.5 %; p = 0.1489. The need to prescribe antibiotics in the groups occurred with approximately the same frequency and was 75.0 and 79.2 % respectively; p = 1.0000. The need for prescribing anti-sinus medications was lower in the experimental group (20.8 %) compared to the control group (41.7 %); p = 0.2129. The consumption of drugs aimed at treating Pseudomonas infection in the experimental group was significantly lower and amounted to 103 compared to 190 NDDD per 1,000 bed days in the control group; p < 0.001. After aerosolization, the number of positive findings on ICU environmental objects decreased by more than two times; p < 0.001. The percentage of microorganisms with altered biochemical characteristics on the significant objects of the Department before treatment was 11.8 % (4), after treatment such microorganisms were not sown. After general cleaning with the use of cleaning probiotics, the share of positive findings in flushes from the Department’s external environment decreased by three times, or from 27 (45.8 %) to 11 (17.2 %), p < 0.001; and the share of microorganisms with altered biochemical characteristics almost four times, or from 9 (15.3 %) to 1 (1.6 %), p = 0.275. Conclusions . 1. In the system of epidemiological control of ICP in the ICU, indoor air aerosolization and cleaning of the hospital environment with the use of probiotics showed high efficiency in reducing the microbial load in the Department. 2. The Pseudovac vaccine did not significantly affect the prevalence of hospital infections in the experimental group. Most notable was a decrease in the consumption of antibacterial drugs and reduce the intake of antibiotics with antidiagonal activity in the vaccinated patients.

INAPPROPRIATE ENDOTRACHEAL TUBE (ETT) CUFF PRESSURE AND ITS RELATION TO VENTILATOR-ASSOCIATED PNEUMONIA (VAP) IN INTENSIVE CARE UNIT (ICU)

TYPE: Abstract Publication TOPIC: Respiratory Care PURPOSE: The respiratory therapist has a major role in preventing nosocomial infection in ICU. One of the most common infections with mechanically ventilated patients is VAP. Inappropriate ETT Cuff measure is one of the main risk factors for microaspiration and VAP. To help reduce this issue, we aimed to observe and investigate medical errors during respiratory therapy in ICU. METHODS: An observational study conducted done by three trained researchers over a period of 65 days, in two ICUs with a total of 56 ICU Beds capacity. The observational study was followed by 20 semi-structured interviews with the staff of respiratory therapy department in each ICU to explore their understanding of the observed incidents and the contributing factors. All discussions and detailed notes taken were transcribed, qualitatively analyzed using line by line coding and then synthesized into narrative themes. We used NVivo-11 to organize and manage the data. RESULTS: During the observational periods, a total of twenty-four patients developed VAP. Among these patients eight patients (33%) were exposed to inappropriate ETT cuff pressure. No fatality was reported as a result of VAP until the study was concluded. CONCLUSIONS: Patients with ETT cuff pressures which are outside the recommended range may be at increased risk of developing VAP and further complications. Poor cuff pressure management could increase ICU days and prolong the use of mechanical ventilation. CLINICAL IMPLICATIONS: We recommended that the staff be educated about the consequences of poor cuff pressure management and the complications which may arise as a result. DISCLOSURE: No significant relationships. KEYWORDS: VAP, patient safety, mechanical ventilation

Prevalence of Streptococcus pneumoniae in Ventilator-Associated Pneumonia by Real-time PCR

Background: Despite the clinical importance of ventilator-associated pneumonia (VAP) as the most common nosocomial infection in ICU, there are few studies in Iran evaluating the bacterial causative agents involving VAP. Objectives: The aim of the present study was to determine the prevalence of bacterial agents of VAP, and to evaluate the presence of S. pneumoniae in VAP- confirmed ICU patients by real-time PCR. Methods: In this cross-sectional study, during March 2016 to March 2017, 50 tracheal aspirates were collected from VAP-confirmed ICU admitted patients in Tehran. The number of epithelial cells and white blood cells (WBC) were determined by direct microscopy. Bacterial identification from VAP samples was done by routine biochemical tests and culturing on differential media. DNA was extracted from samples, and based on lytA gene amplification, a quantitative real-time PCR was performed for S. pneumoniae detection and quantification. Results: In culture, a pure bacterium was isolated from 40 out of 50 samples (80%), with Klebsiella pneumoniae (26%) and Acinetobacter ssp. (18%) being the most common isolates, respectively; however, all cultures were negative for S. pneumoniae. By real-time PCR, two samples (4%) were positive for S. pneumoniae with 4×104 and 1.6×105 CFU/mL bacterial load. These two samples contained 10 and 12 WBC/lpf, respectively. Conclusions: Although with only a with few clinical samples, this is the first study reporting pneumococcal VAP in Iran. Furthermore, in regards to the importance of VAP in ICU patients, more studies to optimize cultural method and evaluate applicable diagnostic molecular methods could be appreciated.

Effect of Endotracheal Tube with Subglottic Suction Port vs Standard Endotracheal Tube on Incidence of Ventilator Associated Pneumonia in Patients of Organo-Phosphate Poisoning

Ventilator associated pneumonia is a hospital acquired infection that develops after 48 hours or more after a patient is intubated with an endotracheal or tracheostomy tube and is put on mechanical ventilation [1]. Ventilator associated pneumonia is most common nosocomial infection in ICU and associated with prolonged hospitalization, increased health care costs, and high attributable mortality. Intubation independently increases the risk of developing nosocomial pneumonia atleast seven fold with a peak incidence occurring around day five of ventilation [2]. Tracheal intubation thwarts cough reflex, compromises mucociliary clearance, injures tracheal epithelial surface, provides a direct conduct for rapid access of bacteria from upper into lower respiratory tract and allows formation of biofilm on Endotracheal tube surface. The combination of these factors puts mechanically ventilated patient at great risk of developing VAP. Aims and Objectives: To study incidence of VAP in ET tube with subglottic suction port versus standard ET tube in cases of O.P poisoning in J.J.M Medical college, Davangere from December 2015-June 2017. Material and Methods: A prospective observational case control study of 80 patients admitted to Red Zone/ICU of J.J.M. Medical College, Davangere. Results: Patients who have presented with Organophosphorous poisoning between the age group of 18 to 60 years who require ventilator support, intubated with standard ET tube and another sub set of patients intubated with ET tube with subglottic suction port were analysed. In this study we found that distribution of various organisms with regards to sputum culture in both groups were pseudomonas being maximum and proteus was found in minimum percentage. When subglottic suction port is used we observed improved patients were 70% and deaths were 30%. When subglottic suction port is not used we observed improved were 55% and death were 45%. Conclusion: VAP is common in patients who are intubated in ICU, which has higher morbidity and mortality among these patients. In our study we observed that atropine usually decreases secretions, but here in this study patient population who were admitted developed secretions instead of adequate atropine dosage and also developed VAP. Use of ET tube with Subglottic suction drainage may prevent VAP in cases of Organo Phosphorous poisoning and also improves patient outcomes.

Impact of nursing work environment on the occurrence of nosocomial infections in ICU

Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1 890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU happen were 60.4% (surgical site infection,1 122/1 858),68.0%(urinary tract infection,1 265/1 859),52.9%(central line infection, 981/1 856), and 66.0%(ventilator associated pneumonia, 1 229/1 861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR: 0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU. Key words: Intensive care units; Nursing work environment; Nosocomial infection

The Incidence and Risk Factors of Nosocomial Infections in ICU

AbstractIntroduction: The increased incidence of nosocomial infections in intensive care units, with frequent occurrence of multiresistant pathogens increase mortality and often raises therapeutic problems.Objectives: to assess the incidence of nosocomial infections, and risk factors.Methods: The study includes 125 patients hospitalized in the Clinic of Anesthesiology and Intesive Care in the Emergency County Hospital and Cardiovascular Surgery Targu Mures. The patients were divided into two groups: the control group (n = 99), patients who did not develop infections during hospitalization in the ICU and the group with infection (n = 26).Results: The incidence of nosocomial infections in our intensive care unit was 19.1%, the most common pathogen being Acinetobacter baumanii. There were no significant differences between the two groups regarding demographic data, the most important risk factor was chronic alcohol consumption. SAPS II. and SOFA scores showed higher values in the group with infection on the day of admission. This group showed lower levels of arterial blood oxygen (Horowitz index), lower sodium level, and higher number of platelets compared to the control group. The mortality in the group with infection was 47.65% compared to the control.Conclusions: Nosocomial infections in critically ill patients are associated with hypoxemia, thrombocytopenia, hyponatremia and a bad outcome.

Evolution ventilator associated pneumonia (VAP) in our intensive care unit, after pneumonia zero (PZ) program implementation

The National Survey of Nosocomial Infection Surveillance (ENVIN) is a computerized record of the incidence of nosocomial infection in ICU in Spain. Most international scientific societies have developed their own recommendations to avoid VAP. In our hospital, we have drafted rules for the maintenance of the airway in mechanically ventilated patients following general recommendations (PZ).

MEDIDAS DE PREVENÇÃO E CONTROLE DAS INFECÇÕES HOSPITALARES EM UNIDADE DE TERAPIA INTENSIVA

Objective: to identify the importance of prevention and control of hospital infections in the intensive care unit. Method: this is a descriptive study with support in the literature review in which it was carried out the survey of information through scientific articles available in the following databases: Scielo, Lilacs and VHL, as well as in books and health magazines. The articles were selected and analyzed. Then began the discussion between the authors. We selected 20 articles in the databases and in magazines, but only 10 were used, as they approached the proposed theme. Results: were divided into four categories for discussion, and the same: Intensive Care Unit; Nosocomial infections in ICU; Measures for the prevention and control of hospital infections in ICU; and control commissions / IH control services. Conclusion: prevention of hospital infections comprise the standard precautions, hand hygiene is the most effective single measure to prevent such injury; and measures of precaution transmission. The Commission and

MICROBIOLOGICAL STUDY OF VENTILATOR-ASSOCIATED PNEUMONIA (VAP) AFTER IMPLANTATION OF PNEUMONIA PROGRAM ZERO (NZ)

The National Survey of Nosocomial Infection Surveillance (ENVIN) is a computerized record of the incidence of nosocomial infection in ICU in Spain. In our hospital, we have drafted rules for the maintenance of the airway in mechanically ventilated patients following general recommendations.

PP-037 Frequency and related factors of nosocomial infections in ICU of tertiary hospital in Tehran, Iran, according to NNIS

PP-037 Frequency and related factors of nosocomial infections in ICU of tertiary hospital in Tehran, Iran, according to NNIS

Nosocomial infections in ICU comparing HIV infected and not infected patients

This study describe the epidemiology of nosocomial (NI) notified at ICU in a tertiary level teaching hospital specialized in infectious diseases comparing adults patients HIV infected and not infected

Nosocomial infections in ICU

Studied the sensitivity of 457 strains of hospital-mikroorgani zmov isolated from patients' ICU and intensive care "GKB number 1", to antibiotics disco-diffusion method. Strains of Acinetobacter spp. and Pseudomonas aeruginosa had a high resistance of most antibacterial agents, but were sensitive to netilmitsinu, meropenem, and polymixin B. In infections caused by representatives of the family Enterobacteriaceae, can be used for the treatment of carbapenems (meropenem and imipenem), cephalothin, and fluoroquinolones. Enterococcus spp. maintained 100% sensitivity to linezolid, in 64,7% - to ofloxacin, in 61,8% - to vancomycin and 54,3% - to ciprofloxacin. Staphylococcus aureus oksatsillinorezistentnye amounted to 72,6%, they are in 100% of cases were susceptible only to linezolid, in 96,7% - to fusidic acid and a new aminoglycoside antibiotics - netilmitsinu (79.3%) and amikacin (65.2%). Among the coagulase negative staphylococci were not allocated to the resistant strains glycopeptide antibiotics and cephalothin, oksatsillinoustoychivymi were 38,5% of cultures.

Targeted surveillance on nosocomial infection in ICU

Objective To analyze the slate and risks of nosocomial infection and establish an effective control of nosocomial infection through developing the targeted surveiUanee.Motheds From Jan to Dec 2007,nosocomial infection was monitored among the patients in a comprehensive ICU.Results 563 eases were selected as the supervision targets,99 patient-times with nosocomial infection were found out and the incidence of infection casetimes was 17.58% with a daily incidence of 34.93‰ and an adjusted daily incidence of 8.71‰.The rate of ventilator associated pneumonia was 35.17‰ occupying 67.68% of the total number of the hospital infection in the ICU.Over the same time,the rate of catheter-related blood stream infections was 2.6‰ and that of catheter associated urinary tract infections was 1.08‰.Conclutions Nosocomial infection rate in a comprehensive ICU could be decreased through targeted surveillance by surveying the infection risk factors and developing effective control especially the using of respirator. Key words: ICU; Targeted Surveillance; Nosocomial infection

Surveillance results of nosocomial infections of the ICU in Kenézy Hospital, based on two years data

According to data in the literature, the number of nosocomial infections in the ICU is far higher than in non-ICU patients. As a result of improving lifesaving technologies, the risk of nosocomial infections increases in ICUs. Utilization of epidemiological methods is recommended for the detection and follow up of nosocomial infections. Prospective surveillance to assess the epidemiology of nosocomial infections in an ICU. Kenézy Hospital is a country hospital with 1637 beds and a 16-bed central ICU. During the investigated period (01. 04. 2004-31. 03. 2006) 1490 patients, with a total 8058 ICU days, were hospitalised in the mixed medical-surgical ICU. The commonest primary diagnosis were respiratory failure, multiple trauma and head injury. Surveillance was performed by a trained infection control nurse and was supervised by an infection control physician and infectious disease physician. CDC definitions were used to define nosocomial infections. A total of 194 nosocomial infections in 134 patients were detected during the study period. The overall incidence and incidence density of nosocomial infections were 13.0 per 100 patients and 24.0 per 1000 patient-days. Respiratory tract infections (44.3%) were the most frequent nosocomial infection, followed by urinary tract (21.1%) and bloodstream infections (20.1%). Nosocomial surveillance is useful in detecting nosocomial infections in ICU. A multidisciplinary approach and partnership between the physicians and infection control nurses is needed. Patient-to-nurse ratio is an independent risk factor for nosocomial infections in intensive care, this must be kept in mind when planning rationalization of the number of nursing staff.

Prospective Study To Evaluate Device-Associated Nosocomial Infection Rates in Intensive Care Units in a Brazilian Public Hospital: Benchmark with NNIS American Rates

OBJECTIVES: To measure the incidence of device-associated nosocomial infections in ICU in Brazil and to compare with NNIS rates. METHODS: We performed a prospective nosocomial infection surveillance study during 3 months in two Brazilian ICUs of one public hospital. Nosocomial infections were identified using the Centers for Disease Control and Prevention National Nosocomial Infections Surveillance (NNIS) system definitions, and site-specific nosocomial infection rates were calculated. RESULTS: We collected data on 171 patients, 670 bed days, 602 central vascular catheter days, 404 mechanical ventilator days, and 592 urinary catheter days. The overall nosocomial infection rate was 15.2% (26/171) and 38.8 per 1000 patient days (26/670). The most common site of infection was central venous catheter–related bloodstream infection (CBSI) (61.5%, 16/26), followed by ventilator-associated pneumonia (VAP) (23.07%, 6/26) and catheter-associated urinary tract infection (CA-UTI) (15.38%, 4/26). The CBSI rate was 26.57 per 1000 device days (16/602) (benchmark with NNIS rate, RR: 6.96; CI 95% 4.26–11.37; p=0.0000). The VAP rate was 12.37 per 1000 device-days (5/404) (benchmark with NNIS rate, RR: 1.41; CI 95% 0.59–3.40; p= 0.43). The symptomatic CA-UTI rate was 6.75 per 1000 device-days (4/592) (benchmark with NNIS rate, RR: 1.72; CI 95% 0.65–4.59; p= 0.27). CONCLUSION: When compared with NNIS rates, we found our CBSI rate was seven times NNIS rates, our VAP rate 1.4 times the NNIS rate, and our CA-UTI rate 1.7 times the NNIS rate. In Brazilian public hospitals, we need to develop interventions to reduce nosocomial infections, especially CBSIs.

Infections urinaires nosocomiales en réanimation : moyens de prévention et mise en application

Nosocomial urinary tract infection (NUTI) is the second most frequent nosocomial infection in ICU. Decreasing the infectious risk can only be achieved by targeting indications, and duration of catheterizing. Inserting a urinary catheter is often performed under aseptic surgical conditions even though the efficacy of this procedure has not been demonstrated in ICU. Several studies have reported that using catheters coated with antiseptics or antibiotics decreases the frequency of UTIs, but induces overcosts. The closed system remains a reference technique. Basic body hygiene seems to be efficient enough for daily care. To conclude, the prevention of UTIs is linked to the quality of care, especially nursing care, and for some a marker of the quality of care.