Invasive device-associated hospital infection rate, etiological agents, and their antibiotic susceptibilities in Medical Intensive Care Unit of Gaziantep University Medical Faculty

The invasive device-associated hospital infections (IDAHI) which constitute an important part of hospital infections create enormous danger especially for the patients who are hospitalized in intensive care units (ICU). IDAHI accounts for approximately %10-15 of all hospital infections. It is an important cause of increased mortality and morbidity. This study was conducted with the aim of determining the rate, etiological agents, and antibiotic susceptibilities of etiological agents of IDAHI in Medical Intensive Care Unit (MICU) of our hospital.Between 2007 February-2009 December, the patients who were hospitalized in MICU of our hospital longer than 48 hours and were older than 16 years were included in our study. Active surveillance directed to the target was performed prospectively. Centers for Disease Control and Prevention (CDC) were used for the definition and diagnosis of IDAHI. The rates of invasive device use and IDAHI were calculated. The distribution of IDAHI rates, isolated etiological agents, and their antibiotic susceptibilities according to the years were evaulated with SPSS 11.5 version and compared by the Z-test.During a 3-year study period, 780 IDAHI was estimated in 1650 patients. Ventilator associated pneumonia (VIP), catheter-associated urinary tract infection (CA-UTI), and central venous catheter-associated blood stream infection (CVCA-BSI) were observed in 415, 242, and 143 of IDAHI, respectively. The most frequently isolated etiological agents were Acinetobacter spp. in VAP, coagulase-negative staphylococci (CoNS) in CVCA-BSI, and candida spp. and E. coli in CA-UTI. A significant increase in cephaperazon-sulbactam resistance of Acinetobacter spp. was observed. Whereas oxacilline resistance according to the years were demonstrated as %94, %84, %82 for coagulase-positive staphylococci (CPS) and %100, %100, %84 for CNS, vancomycine resistance according to the years was determined as %36, %29, %6 for Enterococcus spp..It is essential to perform active surveillance directed to the target regularly and avoid from unnecessary use of invasive devices to reduce IDAHI rate in ICU. However, clinicans should develop policies on use of antibiotics and adaptation to these policies should be strict. It is also crucial to train health-care professionals regularly for increasing their accommodation to standard isolation precautions and hand hygiene.Anahtar Kelimeler: Intensive care unit, the use of invasive devices, surveillance