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Published on: April 26, 2015
Nosocomial infections: current situation in a resuscitation-unit
Background:
The nosocomial infection (NI) is defined as an infection that is not present or incubating on admission in establishment of care. It can be caused by the patient's germs, care personnel or hospital environment. Multidrug resistant (MDR) bacteria are particularly common in intensive care units that lead to a serious infections and increase morbidity, mortality and cost of care.
Purpose:
To identify the epidemiological characteristics of NI, the predisposing factors, the antimicrobial sensitivity pattern of isolated bacteria and the impact on morbidity and mortality.
Methods:
Observational study over the year 2013. All infected patients hospitalized for at least 48 hours were included unless infection has been documented at admission. The type of sampling and bacteriological analyzes were performed based on the infection site according to the classification of Coordination Committee for the Fight against Nosocomial Infection of 2012. Statistical analysis was performed using the SPSS software 20. A p value <0.05 was considered significant.
Results:
63 patients were included with an average age of 51 years and SAPS II at 38. 95% of included patients were ventilated and 100% had a central catheterization. 164 infectious episodes were documented. The number of infection episodes per patient was statistically correlated with the length of stay. The most common isolated microorganism was Acinetobacter baumannii. It remains sensitive to colistin in 87.5% of cases. It was noted an emergence of Carbapenemase Producing Enterobacteriaceae (12%). The major identified risk factors were: previous organ failure, sepsis and catecholamines use (respective OR at 2.72, 2.56 and 2.15). Death was attributed to nosocomial infection in 36.6% of cases.
Conclusion:
The incidence of nosocomial infections is constantly rising in intensive care units. Pneumonia remains the most common infectious site. Contributing factors are an anterior organ failure, sepsis and catecholamines use. Approximately, one infected patient among three died by nosocomial infection.
Insights
Nosocomial infections (NI) in intensive care units are increasing, with pneumonia being the most common. Key risk factors include organ failure and sepsis, leading to significant mortality.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Epidemiology
Background:
- Nosocomial infections (NI) are acquired during healthcare, posing risks due to multidrug-resistant (MDR) bacteria in intensive care units (ICUs).
- NI contributes to increased patient morbidity, mortality, and healthcare costs.
Purpose of the Study:
- To determine the epidemiological profile of NI in an ICU setting.
- To identify predisposing factors for NI.
- To analyze the antimicrobial susceptibility of isolated pathogens and the impact of NI on patient outcomes.
Main Methods:
- An observational study conducted in 2013 included patients hospitalized for over 48 hours without prior infection.
- Infection sites were classified, and bacteriological analyses were performed.
- Statistical analysis used SPSS software, with a significance level of p < 0.05.
Main Results:
- 63 patients were studied, with a mean age of 51 and SAPS II score of 38. 95% required ventilation, and 100% had central catheterization.
- 164 infectious episodes were recorded, with infection frequency correlating with length of stay.
- Acinetobacter baumannii was the most common isolate, 87.5% sensitive to colistin. Carbapenemase-producing Enterobacteriaceae emerged (12%). Risk factors included organ failure, sepsis, and catecholamine use.
Conclusions:
- Nosocomial infections are a growing concern in ICUs, with pneumonia being the most frequent type.
- Previous organ failure, sepsis, and catecholamine administration are significant risk factors for NI.
- Approximately one-third of infected patients in the ICU setting died due to nosocomial infections.
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