Barış BALASAR, Mustafa Çağrı ERGÜN, Betül ERGÜN, Esma EROĞLU

Assessment of Healthcare Associated Infections in a Medical Intensive Care Unit

Objective: This study was undertaken to assess the current status of healthcare associated infections (HAIs) in our institution during a 2-year period in relation to causative agents and their distribution, use and duration of invasive mechanical ventilation, and infection rate and incidence in comparison with national data. Methods: Patients admitted to Medical ICUs of Meram State Hospital between 1st Jan 2019 and 31st Dec 2020 wereincluded. During a 2-year period a total of 47 patients were diagnosed with HAIs based on Centers for Disease Control and Prevention (CDC) and National Nosocomial Infection Surveillance Network (NNISN) criteria. Results: During 6041 follow-up days for 922 patients admitted to ICU, a total of 47 HAIs cases were detected. The most common types of HAIs included healthcare-associated pneumonia in 21 patients (45.6%) and other infections of the respiratory system in 12 patients (26.1%). The most common causative agent was Acinetobacter baumannii, which was found in 27 patients (50.9%). Conclusion: HAIs is an unavoidable condition in ICUs owing to a number of factors such as frequent use of invasive devices, prolonged length of admission, and increased number of complications. One of the major health targets in healthcare facilities is to control an manage HAIs. Avoidance from unnecessary catheterizations, timely removal of invasive catheters, increased adherence to infection control measures, prevention of inappropriate antibiotic use, compliance with isolation procedures, and initiation of appropriate antibiotherapy based on documentation of causative organisms will significantly reduce HAIs incidence.

Keywords:

Healthcare-associated infection, surveilance, pneumonia,

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1.Eroğlu E. Evaluation of Nosocomial InfectionsDeveloping in Neurology Intensive Care Unit.Turkiye Klinikleri J Intern Med. 2020;5(2):49-54doi:10.5336/intermed.2019-72948
2.Yılmaz G, Tașdan İ, Kaymakçı S, Öztürk S, Çırpan E,Atmaca E et al. Invasive device related infectionrates of intensive care units in Ankara UniversityFaculty of Medicine Hospital in 2012 and 2013.Ankara Üniversitesi Tıp Fakültesi Mecmuası.2013;66(3). doi:10.1501/Tıpfak_000000850
3.Schreiber PW, Sax H, Wolfensberger A, Clack L,Kuster SP. The preventable proportion of healthcare-associated infections 2005-2016: Systematic review and meta-analysis. Infection Control and Hospital Epidemiology. 2018.
4.Sahin AR, Yıldız BT, Aktemur A, et al. Evaluation ofnosocomialinfections ina neurologicalintensivecareunit ofa universityhospital. J ContempMed 2019; 9: 43-7.
5.Baviskar AS, Khatib KI, Rajpal D, Dongare HC.Nosocomial infections in surgical intensive careunit: A retrospective single‑center study. Int J CritIlln Inj Sci. Published online 2019.doi:10.4103/IJCIIS.IJCIIS_57_18
6.Ulusal hastane enfeksiyonları sürveyans ağı(UHESA) raporu özet veri, 2017.https://hsgm.saglik.gov.tr/depo/Duyurular/Surveyans_Agi_Ozet_Raporu_2017/USHIESA_OZET_RAPOR_2017.pdf
7.Clarke K, Hall CL, Wiley Z, et al. Catheter-Associated Urinary Tract Infections in Adults:Diagnosis, Treatment, and Prevention. Journal of Hospital Medicine. 2020.
8.Akalın Ş, Erkaya N, Göncü F. Yoğun bakımünitesinde hastane infeksiyonlarınınepidemiyolojisi. Hastan İnfeksiyonları Derg.2009;13(2):150-4.
9.1. Ulusal Sağlık Hizmeti İlişkili EnfeksiyonlarSürveyans Ağı (USHİESA) Etken Dağılımı veAntibiyotik Direnç Raporu 2020. Published 2020.https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/ETKEN_DAGILIM_VE_DIRENC_2020.pdf
10.Widmer AF. Infection control and preventionstrategies in the ICU. Intensive Care Med.1994;20(4):S7-11. doi:10.1007/BF01713976
11.Gözütok F, Mutlu Sarıgüzel F, Çelik İ, ve ark..Hastane infeksiyonu etkeni Acinetobacterbaumannii suşlarının antimikrobiyal dirençoranlarının araştırılması. ANKEM Derg.2013;27(1):7-12.
12.Gürbüz A, Sungurtekin H, Gürbüz M, Kaleli İ.Anestezi yoğun bakım ünitesinde görülen hastaneinfeksiyonları. Türk Yoğun Bakım Derneği Derg.2010;8(1):6-12.
13.Ak O, Batirel A, Ozer S, Colakoğlu S. Nosocomialinfections and risk factors in the intensive care unitof a teaching and research hospital: A prospecivecohort study. Med Sci Monit Int Med J Exp Clin Res.2011;17(5):29.
14.Vincent J-L, Rello J, Marshall J, et al. Internationalstudy of the prevalence and outcomes of infection inintensive care units. Jama. 2009;302(21):2323-9.
15.Güzel A, Aktas G, Çelen MK, et al. Beyin cerrahisiyogun bakım ünitesi enfeksiyon etkenleri veantibiyotik duyarlılıkları. Dicle Tıp Derg.2009;36(4):252-7.
16.KAMİT F, ŞENER D. Devlet hastanesi üçüncübasamak çocuk yoğun bakımda çoklu ilaç dirençligram negatif enfeksiyonların değerlendirilmesi.Pamukkale Med J. 2020;
17.Öncül A, Koçulu S, Elevli K. The epidemiology ofnosocomial infections acquired in intensive careunits of a state hospital. Med Bull Sisli Etfal Hosp[Internet]. 2012;46(2):60–6.
18.Ulusal Sağlık Hizmeti İlişkili EnfeksiyonlarSürveyans Ağı (USHİESA) Özet Raporu 2020.Published 2020. https://hsgm.saglik.gov.tr/depo/birimler/Bulasici-hastaliklar-db/hastaliklar/SHIE/Raporlar/USHIESA_OZET_RAPORU_2020.pdf
19.Akın A, Çoruh EA, Kaya AE, Günay Canpolat D.Anestezi Yoğun Bakım Ünitesinde Beş Yıl İçerisindeGelişen Nozokomiyal Enfeksiyonlar ve AntibiyotikDirencinin Değerlendirilmesi. Erciyes Tıp Derg.2011;33(1):7-16.
20.Ertürk A, Çiçek AÇ, Köksal E, Köksal ZŞ, Özyurt S.Yoğun Bakim Ünitesinde Yatan Hastalarin ÇeşitliKlinik Örneklerinden İzole EdilenMikroorganizmalar ve Antibiyotik Duyarliliklari.Ankem Derg. 2012;26(1):1-9.
21.Taşbakan IM, Sipahi OR, Pullukçu H, et al.Nöroşirurji Yoğun Bakım Ünitesinde GörülenHastane Enfeksiyonlarının Değerlendirilmesi. EgeTıp Derg. 2006;45(2):127-30.
22.Tarakçı A, Eroğlu E. The Evaluation ofNosocomial Infections Developing in Intensive CareUnits of a Tertiary University Hospital. J ContempMed 2021;11(2):198-202.