Evaluation of intensive care infections; retrospective 5-year analysis

Introduction and Aim: Intensive care units are the units where infections are seen most frequently. Nosocomial infections in these areas are the most important causes of high mortality for patients and increased costs for hospitals. This study was carried out to determine the prevalence of infection in the anesthesia intensive care unit of our university, the effect of infection development on the length of stay in the intensive care unit and mortality, infectious microorganisms and their resistance to antibiotics. Materials and Methods: In this study, patients over the age of 18 who were followed up and treated for more than 48 hours between 2016 and 2020 at Dicle University, Department of Anesthesiology and Reanimation III. Level ICU were evaluated retrospectively. From these data, the prevalence of infection in the anesthesia intensive care unit, the effect of infection development on the length of stay in the intensive care unit and mortality, infectious microorganisms and their resistance to antibiotics were determined. Results: 561 patients were included in the study. The prevalence of infection originating from the intensive care unit was %20,7 and the overall infection prevalence was %64,9. While the mean hospital stay was 22,95±29,68 days in patients with growth in the infectious agent, it was 8,28±6,78 days in patients without growth (p<0.001). While 104 (%28,6) of 364 patients with infectious agent growth died, 17 (%8,6) of 197 patients without infectious agent growth died (p<0.001). The resistance rates against colistin and trimethoprim-sulfamethoxazole, which are the most effective antibiotics against A.baumanii, were %17,6 and %58,3 respectively, the most effective antibiotics against K. pneumoniae strains were fosfomycin, imipenem and gentamicin, and colistin resistance has %52,9 found to be reached. It was determined that the imipenem and meropenem resistance of P. aeruginosa reached %70-80, and E. Coli was highly resistant to B-lactam antibiotics such as ampicillin, piperacillin, ceftazidime, cefepime and cefuroxime sodium. The vancomycin resistance of E. Faecalis and E. Faecium was found to be %2,9 and %38,0, respectively. Conclusion: The growth of infectious agents causes an average of 14.67 days longer hospital stay and 3.3 times more mortality in patients. In our study, severe carbapenem resistance for A.baumanii and P. Aeruginosa, increased colistin resistance in K. pneumoniae is remarkable. Key Words: Antibiotic resistance, hospital infection, Intensive care units