Examination of the changes in the restructured anesthesia i̇ntensive care unit on infection rates: A retrospective study

The objective of the present study was to retrospectively assess the effects of organizational restructuring in the Anesthesiology Intensive Care Unit, Fırat University on the rates of infections. A complete organizational restructuring was carried out in the Anesthesia Intensive Care Unit of Fırat University Hospital after it was relocated on 14th March 2012. Thus, this study was designed to evaluate the effect of this restructuring on the rates of infection through a comparison of the periods encompassing one year before and after the relocation. The results of physical examination and laboratory tests were recorded on a daily basis. Also, sampling from multiple sites (blood, endotracheal aspirations, wound, urine) was performed for microbiological assessments each week. The results of microbiological cultures were assessed in conjunction with the physical examination, laboratory, and imaging findings. Overall 1011 patients were screened and a Toplam of 406 patients over 18 years of age who were admitted for more than 48 hours with no signs of infection in physical examination, cultures, and laboratory results were included. The patients were allocated into two groups based on the time-point cut-off 14 March 2012. There were 214 and 192 patients in Groups A and B, respectively. The two groups were compared with respect to rates of infection. Our results showed no effect of age, gender, primary diagnosis at admission, mean GKS at admission, mean duration of stay, and concomitant disorders on the rates of infection, while there were statistically significant differences between Group A and B with regard to the rates of infection (41.1% vs 25%, respectively), rates of urinary infection (18.7% vs 10.4%), VİP (32.7% vs. 14.6%), mean duration of mechanical ventilation (15,0116,681/12,2217,595), need for tracheostomy (43% vs. 31.3%) and discharge with improvement (31.8% vs. 44.3%) as well as in terms of the frequency of the detection of certain causative agents including Pseudomonas (15.4% vs. 6.8%), Acinetobacter (18.2% vs. 12), and Escherichia coli (8.9% vs. 2.1%). In conclusion, a restructuring in our unit resulted in a significant drop in the rates of infection with a number of positive consequent changes. Intensive care unit personnel represent a major cause of intensive care unit infections and therefore continuous educational activities and effective surveillance programs may prove to be a leading factor in reducing such infections. Keywords: Intensive care unit, nosocomial infection, surveillance