A Comparative Analysis of Nosocomial Infections between Internal and Surgical Intensive Care Units of a University Hospital in Birjand, Iran from 2015 to 2016: A Retrospective Study

Abstract Background:The aim of this study was to investigate and then to compare the prevalence of nosocomial infections (NIs) in the patients admitted to the surgery and internal Intensive Care Units(ICU) as well as studying the risk factors involved.Methods:In this cross-sectional descriptive, patients admitted to ICUs were studied over a year .Clinical data of patients, including demographic information, length of stay, underlining disease, the rate of patient with NIs and distribution of NIs sites and pathogens were collected. Univariate and multivariate logestic regression were carried out to determine the factors associated with NIs.Results:A total of 1018 patients were studiedincluding surgical ICU (n = 665) and internal ICU (n = 353). The incidence rate of NI in surgical and internal ICUs was 67(10.1%) and 96(27.2%), respectively. The most common NI in the internal ICU were respiratory tract infections( RTI ,46.9%) and urinary tract infections (UTI, 37.5%), while in the surgical ICU, the most common infections were respiratory tract infections (RTI, 38.3%) and surgical-site infections (SSI, 22.0%), respectively. The major factors the length of stay and the use of nasogastric intubation (NG tubes) were associated with NIs in both ICUs.Conclusions:The incidence of infections in the internal ICU were more than the surgical ICU. Age, underlying diseases, the long stay, used of ventilator and NG tube were factors associated with NIs rate in internal ICU.Trial registration:This study was the result of two research works with ethics code (IR.BUMS.REC.1394-17 and IR.BUMS.REC.1394-27).

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Assessment of the intensity of the epidemic process of ventilator-associated respiratory tract infections in patients of surgical intensive care unit

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40868 ◽

2015 ◽

Vol 20 (2) ◽

pp. 37-42

Author(s):

O. A Orlova ◽

V. G Akimkin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Tract ◽

Nosocomial Infections ◽

Respiratory Tract Infections ◽

Abdominal Cavity ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Epidemic Process ◽

Tract Infections

The urgency of the problem of ventilator-associated respiratory tract infections is stipulated by the ever-increasing number of diseases caused by nosocomial polyantibiotic-resistant strains and high mortality rate. Purpose - to give an assessment of the intensity of the epidemic process of ventilator-associated respiratory tract infections in patients of the surgical intensive care unit. In the base of the analysis there were put the results of a comprehensive epidemiological, clinical, and instrumental study of 137 patients (100 patients with severe injuries and 37 patients with diseases of the abdomen and thorax) with ventilator - associated respiratory tract infections received medical treatment in the surgical intensive care unit. The proportion of respiratory tract infections in the structure of nosocomial infections in these patients varies from 34.6 to 58.9 %, in that there was revealed the prevalence of nosocomial pneumonias (63.5 %). When using a ventilator with viral-bacterial filters signs of nosocomial respiratory tract infections were manifested on the 10th day and later in 50.8 % of patients. In cases with the duration of artificial ventilation more than 10 days the risk of the development of these infections in patients with diseases of the abdominal cavity and thorax was 2.1 times higher than in patients with injuries. There was shown the necessity of the development of a set of measures for the prevention of nosocomial infections of the respiratory tract.

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Effectiveness of Oral Rinse with Chlorhexidine in Preventing Nosocomial Respiratory Tract Infections among Intensive Care Unit Patients

Infection Control and Hospital Epidemiology ◽

10.1086/605722 ◽

2009 ◽

Vol 30 (10) ◽

pp. 952-958 ◽

Cited By ~ 43

Author(s):

Fernando Bellissimo-Rodrigues ◽

Wanessa Teixeira Bellissimo-Rodrigues ◽

Jaciara Machado Viana ◽

Gil Cezar Alkmim Teixeira ◽

Edson Nicolini ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Respiratory Tract Infections ◽

Icu Patients ◽

Oral Application ◽

Tract Infections

Objective.To evaluate the effectiveness of the oral application of a 0.12% solution of Chlorhexidine for prevention of respiratory tract infections among intensive care unit (ICU) patients.Design.The study design was a double-blind, randomized, placebo-controlled trial.Setting.The study was performed in an ICU in a tertiary care hospital at a public university.Patients.Study participants comprised 194 patients admitted to the ICU with a prospective length of stay greater than 48 hours, randomized into 2 groups: those who received Chlorhexidine (n = 98) and those who received a placebo (n = 96).Intervention.Oral rinses with Chlorhexidine or a placebo were performed 3 times a day throughout the duration of the patient's stay in the ICU. Clinical data were collected prospectively.Results.Both groups displayed similar baseline clinical features. The overall incidence of respiratory tract infections (RR, 1.0 [95% confidence interval [CI], 0.63-1.60]) and the rates of ventilator-associated pneumonia per 1,000 ventilator-days were similar in both experimental and control groups (22.6 vs 22.3; P = .95). Respiratory tract infection-free survival time (7.8 vs 6.9 days; P = .61), duration of mechanical ventilation (11.1 vs 11.0 days; P = .61), and length of stay (9.7 vs 10.4 days; P = .67) did not differ between the Chlorhexidine and placebo groups. However, patients in the Chlorhexidine group exhibited a larger interval between ICU admission and onset of the first respiratory tract infection (11.3 vs 7.6 days; P = .05). The chances of surviving the ICU stay were similar (RR, 1.08 [95% CI, 0.72-1.63]).Conclusion.Oral application of a 0.12% solution of Chlorhexidine does not prevent respiratory tract infections among ICU patients, although it may retard their onset.

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Treatment of respiratory tract infections with pefloxacin in critically ill patients hospitalized in a surgical intensive care unit

Pharmaceutisch Weekblad ◽

10.1007/bf02075262 ◽

1987 ◽

Vol 9 (S1) ◽

pp. S58-S59

Author(s):

D. M. Boland ◽

W. C. F. van Gestel ◽

D. M. MacLaren ◽

D. de Jong

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Tract ◽

Critically Ill ◽

Critically Ill Patients ◽

Respiratory Tract Infections ◽

Surgical Intensive Care Unit ◽

Surgical Intensive Care ◽

Tract Infections

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Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i2.21098 ◽

2019 ◽

Vol 10 (2) ◽

pp. 14-19 ◽

Cited By ~ 1

Author(s):

Dharm Raj Bhatta ◽

Deependra Hamal ◽

Rajani Shrestha ◽

Supram HS ◽

Pushpanjali Joshi ◽

...

Keyword(s):

Intensive Care ◽

Respiratory Tract ◽

Intensive Care Units ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Bacterial Pathogens ◽

Multidrug Resistant ◽

Lower Respiratory Tract Infections ◽

Acinetobacter Species ◽

Tract Infections

Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

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A Potential Infection Hazard Associated with the Use of Disposable Saline Vials

Infection Control ◽

10.1017/s0195941700059166 ◽

1984 ◽

Vol 5 (4) ◽

pp. 170-172 ◽

Cited By ~ 12

Author(s):

William A. Rutala ◽

Marsha M. Stiegel ◽

Felix A. Sarubbi

Keyword(s):

Intensive Care ◽

Respiratory Tract ◽

Intensive Care Units ◽

Respiratory Tract Infections ◽

Respiratory Therapy ◽

Streptococcus Viridans ◽

The Past ◽

Skin Contact ◽

Tract Infections

AbstractNosocomial respiratory tract infections have occasionally been associated with contaminated respiratory therapy devices and techniques. In the past two years, our hospital purchased disposable saline squeeze vials for use during suctioning of intubated patients. These vials have a cap which must be flipped or twisted-off by the user before the contents can be instilled into the patient's respiratory tract. We observed use of this item in our intensive care units (ICU) and studied the potential for contamination. ICU nurses use ungloved hand(s) to flip or twist-off squeeze vial cups resulting in skin contact with the vial opening. Cultures of nurses' hands and squeeze vial contents were obtained in the ICU where 24 nurses opened 92 vials in the manner previously described. Twenty-three percent of vial contents were contaminated and cultures revealed S. epidermidis, S. aureus, Streptococcus viridans and enterococcus. On six occasions, organisms recovered from vial contents were believed to be identical to organisms isolated from the hands of the nurse who opened the vial. When nurses used care in removing the saline vial cap, cultures of vial contents were sterile.

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