Nosocomial infections and risk factors in intensive care unit of a university hospital in Turkey

Open Medicine ◽  
2010 ◽  
Vol 5 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Burcin Ozer ◽  
Muserref Tatman-Otkun ◽  
Dilek Memis ◽  
Metin Otkun
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Respiratory Tract ◽  
Nosocomial Infections ◽  
Lower Respiratory Tract ◽  
Prolonged Mechanical Ventilation ◽  
University Hospital ◽  
Tract Infections

AbstractThe aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be 68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit.

scholarly journals Nosocomial infections in the Intesive care unit, University hospital for infectious and tropical diseases, Belgrade, Serbia

2014 ◽  
Vol 71 (2) ◽  
pp. 131-136
Author(s):  
Ivana Milosevic ◽  
Milos Korac ◽  
Goran Stevanovic ◽  
Djordje Jevtovic ◽  
Branko Milosevic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Urinary Tract ◽  
Nosocomial Infections ◽  
Statistical Significance ◽  
University Hospital ◽  
Tropical Diseases ◽  
Electronic Data Base ◽  
Tract Infections

Bacground/Aim. Nosocomial infections (NIs) are an important cause of morbidity, mortality and prolonged hospitalizations. Fifty percent of NIs have been reported in Intensive Care Units. The aim of this study was to determine the frequency and type of NIs among critically ill patients treated in the University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, as well as risk factors for acquiring them. Methods. This prospective cohort study included 52 patients treated in the Intensive Care Unit from January to June 2004. The diagnosis of NI was established according to the Centers for Disease Control and Prevention (CDC) definition, based on clinical presentation, radiological and microbiological findings, etc. Statistical data processing was done by using the electronic data base organized in SPSS for Windows version 10.0. The level of statistical significance was defined as p < 0. 05. Results. NIs were found in 33 (63.4%) of 52 inpatients. Urinary tract infections (UTIs), pneumonia, and soft tissue infections, the most common nosocomial infections in our setting, were recorded in 41.0%, 25.6%, and 23.1%, of patients, respectively. Several factors contributed to a high incidence of these infections: chronic comorbidities (p < 0.01), the presence of indwelling devices such as urinary tract catheters (p < 0.01), endotracheal tubes (p < 0.05) along with mechanical ventilation (p < 0.05). Conclusion. The majority of patients with NIs had chronic underlying comorbidities. All the patients with UTIs had urinary catheters. The most important risk factors for the development of nosocomial pneumonias were endotracheal intubation and mechanical ventilation. The patients with pneumonia had the highest mortality.

scholarly journals Hyperimmune globulins in prevention and treatment of respiratory syncytial virus infections.

1995 ◽  
Vol 8 (1) ◽  
pp. 22-33 ◽  
Author(s):  
V G Hemming ◽  
G A Prince ◽  
J R Groothuis ◽  
G R Siber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) is an important community and nosocomial respiratory pathogen for infants and young children. RSV causes especially severe disease in the prematurely born or those with chronic cardiopulmonary diseases. Elderly persons and those with T-cell deficiencies, such as bone marrow transplant recipients, are also at high risk for serious lower respiratory tract infections. To date, prevention of RSV infections by vaccination has proven elusive and no preventive drugs exist. Studies in animals and humans have shown that the lower respiratory tract can be protected from RSV infection by sufficient circulating RSV neutralizing antibody levels. Recently, an RSV hyperimmune immune globulin (RSVIG) was developed and tested for the prevention of RSV infections or reduction of disease severity. Passive immunization of high-risk children with RSVIG during the respiratory disease season effected significant reductions in RSV infections, hospitalizations, days of hospitalization, intensive care unit admissions, days in the intensive care unit, and ribavirin use. Studies in cotton rats and owl monkeys show that RSV infections can also be treated with inhalation of immune globulin at doses substantially smaller than required for parenteral treatment. Therapeutic trials of parenteral RSVIG have been completed and are pending analysis. The use of polyclonal, hyperimmune globulins and perhaps human monoclonal antibodies provides an additional approach to the prevention and perhaps the treatment of certain viral lower respiratory tract infections such as those caused by RSV.

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

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.

scholarly journals Catheter-associated urinary tract infection in a surgical intensive care unit

2015 ◽  
Vol 72 (10) ◽  
pp. 883-888 ◽  
Author(s):  
Jovan Mladenovic ◽  
Milic Veljovic ◽  
Ivo Udovicic ◽  
Srdjan Lazic ◽  
Zeljko Jadranin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nosocomial Infections ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care

Background/Aim. Because patients in intensive care units usually have an urinary catheter, the risk of urinary tract infection for these patients is higher than in other patients. The aim of this study was to identify risk factors and causative microrganisms in patients with catheter-associated urinary tract infection (CAUTI) in the Surgical Intensive Care Unit (SICU) during a 6-year period. Methods. All data were collected during prospective surveillance conducted from 2006 to 2011 in the SICU, Military Medical Academy, Belgrade, Serbia. This case control study was performed in patients with nosocomial infections recorded during surveillance. The cases with CAUTIs were identified using the definition of the Center for Disease Control and Prevention. The control group consisted of patients with other nosocomial infections who did not fulfill criteria for CAUTIs according to case definition. Results. We surveyed 1,369 patients representing 13,761 patient days. There were a total of 226 patients with nosocomial infections in the SICU. Of these patients, 64 had CAUTIs as defined in this study, and 162 met the criteria for the control group. Multivariate logistic regression analysis identified two risk factors independently associated to CAUTIs: the duration of having an indwelling catheter (OR = 1.014; 95% CI 1.005-1.024; p = 0.003) and female gender (OR = 2.377; 95%CI 1.278-4.421; p = 0.006). Overall 71 pathogens were isolated from the urine culture of 64 patients with CAUTIs. Candida spp. (28.2%), Pseudomonas aeruginosa (18.3%) and Klebsiella spp. (15.5%) were the most frequently isolated microorganisms. Conclusions. The risk factors and causative microrganisms considering CAUTIs in the SICU must be considered in of planning CAUTIs prevention in this setting.

scholarly journals Budget impact analysis of using procalcitonin to optimize antimicrobial treatment for patients with suspected sepsis in the intensive care unit and hospitalized lower respiratory tract infections in Argentina

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250711
Author(s):  
Osvaldo Ulises Garay ◽  
Gonzalo Guiñazú ◽  
Wanda Cornistein ◽  
Javier Farina ◽  
Ricardo Valentini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Health System ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Budget Impact ◽  
Lower Respiratory Tract Infections ◽  
Suspected Sepsis ◽  
Tract Infections

Background Inappropriate antibiotic use represents a major global threat. Sepsis and bacterial lower respiratory tract infections (LRTIs) have been linked to antimicrobial resistance, carrying important consequences for patients and health systems. Procalcitonin-guided algorithms may represent helpful tools to reduce antibiotic overuse but the financial burden is unclear. The aim of this study was to estimate the healthcare and budget impact in Argentina of using procalcitonin-guided algorithms to guide antibiotic prescription. Methods A decision tree was used to model health and cost outcomes for the Argentinean health system, over a one-year duration. Patients with suspected sepsis in the intensive care unit and hospitalized patients with LRTI were included. Model parameters were obtained from a focused, non-systematic, local and international bibliographic search, and validated by a panel of local experts. Deterministic and probabilistic sensitivity analyses were performed to analyze the uncertainty of parameters. Results The model predicted that using procalcitonin-guided algorithms would result in 734.5 [95% confidence interval (CI): 1,105.2;438.8] thousand fewer antibiotic treatment days, 7.9 [95% CI: 18.5;8.5] thousand antibiotic-resistant cases avoided, and 5.1 [95% CI: 6.7;4.2] thousand fewer Clostridioides difficile cases. In total, this would save $422.4 US dollars (USD) [95% CI: $935;$267] per patient per year, meaning cost savings of $83.0 [95% CI: $183.6;$57.7] million USD for the entire health system and $0.4 [95% CI: $0.9;$0.3] million USD for a healthcare provider with 1,000 cases per year of sepsis and LRTI patients. The sensitivity analysis showed that the probability of cost-saving for the sepsis patient group was lower than for the LRTI patient group (85% vs. 100%). Conclusions Healthcare and financial benefits can be obtained by implementing procalcitonin-guided algorithms in Argentina. Although we found results to be robust on an aggregate level, some caution must be used when focusing only on sepsis patients in the intensive care unit.

Handwashing Program for the Prevention of Nosocomial Infections in a Neonatal Intensive Care Unit

2004 ◽  
Vol 25 (9) ◽  
pp. 742-746 ◽  
Author(s):  
Sau-Pin Won ◽  
Hung-Chieh Chou ◽  
Wu-Shiun Hsieh ◽  
Chien-Yi Chen ◽  
Shio-Min Huang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Respiratory Tract ◽  
Neonatal Intensive Care Unit ◽  
Nosocomial Infections ◽  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Tract Infections

AbstractObjective:To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU).Design:Open trial.Setting:A level-III NICU in a teaching hospital.Participants:Nurses, physicians, and other healthcare workers in the NICU.Interventions:A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed.Results:Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P = .003) with improved handwashing compliance. In particular, respiratory tract infections decreased from 3.35 to 1.06 per 1,000 patient-days during the handwashing campaign (P = .002). Furthermore, the correlation between nosocomial infection of the respiratory tract and handwashing compliance also reached statistical significance (r = -0.385; P = .014).Conclusions:Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular. Washing hands is a simple, economical, and effective method for preventing nosocomial infections in the NICU

Sign in / Sign up

Export Citation Format

Share Document