Evaluation of Nosocomial Infections in Reanimation Intensive Care Unit: Analysis of Six Years Surveillance

Objective: Nosocomial infections (NI) raise costs due to the increased in mortality and long-term hospitalization. There are more NIs in intensive care units (ICU) probably due to invasive procedures. In order to reduce NIs, the most important step in terms of prevention is the identification of the common pathogens with their infection rates among these units. For this purpose, the centers should conduct surveillance studies and often evaluate their data. Methods: We evaluated the infection rates and ratios, between January 1st, 2014 and August 31st, 2019 in Reanimation Intensive Care Unit (ICU) in our hospital. Method of the surveillance was, prospective, active, laboratory and patient based. Results: In our reanimation ICU, 1591 patients were followed up during the study period. 192 NIs were observed in 179 patients on 21,840 intensive care days. NI rate was found to be 11.25 and Infection density rate was found to be 8.20 and their change over the years was examined. Analysis regarding the source of infections revealed that ventilator-related pneumonia (27.08%) and central venous catheter-related blood-stream infection (25.52%) was most commonly observed during the study period. The ventilator usage rate was 0.54 (11.859 ventilator days) and the central venous catheter usage rate was 0.94 (20.566 catheter days) in the study period. Acinetobacter baumannii (n = 96, 50%), Pseudomonas aeruginosa (n = 24, 12.5%) and Klebsiella pneumonia (n = 18, 9.38%) were most commonly isolated.

Reanimasyon Yoğun Bakım Ünitesinde Gelişen Nozokomiyal Infeksiyonların Değerlendirilmesi: Altı Yıllık Sürveyans Verilerinin Analizi

Amaç: Nozokomiyal enfeksiyonlar (NE) artmış mortalite ve uzayan yatışlar sonucu maliyet artışına sebep olurlar. Özellikle uygulanan invaziv girişimlere bağlı olarak oranlar yoğun bakım ünitelerinde (YBÜ) daha yüksektir. NE’leri azaltabilmek için merkezlerin daha ötesi ünitelerin kendi enfeksiyon oranlarını izlemesi sık görülen patojenleri bilmesi yapılacak önleme faaliyetleri açısından en önemli basamaktır. Bu amaçla merkezler sürveyans çalışmaları yürütüp verilerini düzenli olarak değerlendirirler. Yöntemler: Bu çalışmada 1 Ocak 2014 – 31 Ağustos 2019 tarihleri arasında hastanemiz Reanimasyon YBÜ‘nün enfeksiyon hızları ve oranları değerlendirilmiştir. Çalışma, laboratuar ve hasta temelli olarak yürütülen aktif sürveyans verileri prospektif olarak incelenmiştir. Bulgular: Sonuç olarak çalışma döneminde reanimasyon yoğun bakım ünitemizde 1591 hasta takip edilmiştir, 21.840 yoğun bakım gününde 179 hastada 192 NE atağı izlenmiştir. NE hızı:11,25; Enfeksiyon dansite hızı: 8.20 olarak bulunmuş ve yıllara gore değişimi incelenmiştir. Tüm çalışma boyunca İnvaziv alet ilişkili enfeksiyon oranları değerlendirildiğinde, %27,08’i ventilator ilişkili pnömoni, %25,52’si santral venöz kateter enfeksiyonu olarak bulundu. Çalışma döneminde ünitedeki ventilator kullanım hızı:0,54 (11.859 ventilatör günü) ve santral venöz kateter kullanım oranı: 0,94 (20.566 kateter günü) olarak hesaplanmıştır. En sık olarak üreyen etken yıllara göre değişmekle birlikte toplamda Acinetobacter baumannii (n=96, %50), Pseudomonas aeruginosa (n=24, %12,5), Klebsiella pneumonia (n=18, %9,38), Candida spp. (n=20, 10,4%) izole edilmiştir.

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