Evaluation of hospital acquired infections in the tertiary intensive care unit: a three-year analysis

Introduction: Hospital-acquired infections (HAI) occurring in intensive care units (ICUs) are an important risk factor for mortality and morbidity. In some patient groups followed in ICUs, the risk of developing nosocomial infections increases even more. Especially, patients with end-stage renal disease (ESRD) carry a serious risk for HAI when they are hospitalized in ICUs. Our aim is to determine the rate and incidence of hospital infection, the distribution of infections and the most common microorganisms in our ICU, to initiate appropriate empirical treatment and to prevent the development of antibiotic resistance. Material and Method: A total 158 patients with a diagnosis of hospital-acquired infection hospitalized between January 2017 and December 2019 at general internal medicine intensive care unit, were included in this study. The clinical findings, culture results and laboratory data of the patients were recorded. According to years, the HAI rate, density and infection agents in the ICU were determined. Results: 158 episodes of nosocomial infections were detected in 128 of 556 patients who were hospitalized within three years. The hospitalization day was 9048, and the three-year ICU HAI rate was calculated as 29.19%. HAI density was 17.45 in 1000 patient days. Bloodstream infection was the most common (30.38%), followed by ventilator-associated pneumonia (28.48%) and catheter-related urinary tract infection (24.68%). Gram-negative microorganisms were the most common infectious agents. Among the Gram-negative bacteria, the most frequently isolated bacteria were A. baumannii, K. pneumoniae and P. aeruginosa. Among Gram-positive bacteria, Enterococcus spp. was most frequently isolated Conclusion: The risk of HAI is high in patients hospitalized in ICUs. In order to control nosocomial infections, HAI incidences and rates should be evaluated, infectious agents, and prospective effective infection control strategies should be developed by taking necessary precautions according to surveillance results. These measures will significantly reduce the incidence of HAI.

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