[DEVICE-ASSOCIATED HEALTHCARE INFECTION AND SEPSIS IN INTENSIVE CARE UNIT]

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Hospital Epidemiology

Background:

• Healthcare-associated infections (HAIs) and sepsis are 5-10 times more prevalent in intensive care units (ICUs) compared to other hospital settings.
• Intrinsic factors (e.g., disease severity, immunosuppression) and extrinsic factors (e.g., broad-spectrum antibiotic use, antibiotic-resistant pathogens) contribute to HAI risk.
• Device-associated HAIs (DA-HAIs) constitute a significant proportion of HAIs in ICUs, with varying incidence across different ICU types.

Purpose of the Study:

• To highlight the prevalence and types of device-associated healthcare-associated infections (DA-HAIs) in intensive care units (ICUs).
• To identify common pathogens, particularly resistant gram-negative bacilli, associated with DA-HAIs.
• To underscore the impact of DA-HAIs on patient outcomes and healthcare costs, emphasizing the need for effective prevention strategies.

Main Methods:

• Review and analysis of incidence rates of various device-associated healthcare-associated infections (DA-HAIs) across different intensive care unit (ICU) types.
• Identification of frequently isolated pathogens in DA-HAIs, distinguishing between gram-positive and gram-negative bacteria.
• Examination of the clinical and economic consequences of DA-HAIs.

Main Results:

• Device-associated healthcare-associated infections (DA-HAIs) account for a substantial percentage of HAIs in intensive care units (ICUs), with incidence rates varying widely (2%-49%).
• Central line-associated bloodstream infections (CLA-BSI), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSI) are the most frequent DA-HAIs.
• Resistant gram-negative bacilli (e.g., Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter spp.) are increasingly implicated in DA-HAIs, alongside a rise in urinary and systemic infections.

Conclusions:

• Device-associated healthcare-associated infections (DA-HAIs) pose a significant threat to patient recovery in ICUs, leading to prolonged hospital stays and increased mortality.
• The DA-HAI rate serves as a crucial metric for surveillance and evaluating the effectiveness of preventive measures within and between ICUs.
• Effective strategies for preventing DA-HAIs are essential for improving patient safety and reducing the economic burden on healthcare systems.