Device-associated, device-day infection rates in an Israeli adult general intensive care unit.
Surveillance is an essential element of hospital infection control programs. Previous studies have shown that interhospital comparison of intensive care unit (ICU) nosocomial infections (NI) may be best made by comparing ICU-type-specific, device-associated infection rates and that these adjusted rates vary by ICU type. The aim of this study was to evaluate whether significant structural improvements introduced in an adult general ICU were associated with changes in the NI rates in this unit. In addition, we compared these rates with those of ICUs reported by the National Nosocomial Infections Surveillance (NNIS) System of the Centers for Diseases Control and Prevention. During a 12-month period 337 patients were surveyed. There were 20 ventilator-associated pneumonias (VAP)/1000 ventilator (VEN)-days, 12 bloodstream infections (BSI)/1000 central vascular catheter (CVC)-days and 14 urinary tract infection (UTI)/1000 indwelling urinary catheter (IUC)-days. Structural changes and reduction in device utilization ratios were not followed by change in NI rates in this unit. VAP and BSI rates were comparable to those reported for neurosurgical and burn ICUs, respectively, in the NNIS System, despite a much higher device utilization ratios. The present study provides specific surveillance data for further interhospital comparison with similar types of ICUs.
Finkelstein
R
R
Infectious Diseases Unit, Rambam Medical Center Technion-Israel Institute of Technology, Faculty of Medicine Haifa, Israel. rfinkelstein@rambam.health.gov.il
Rabino
G
G
Kassis
I
I
Mahamid
I
I
D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000706:statistics & numerical data; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D004352:Drug Resistance, Microbial; D004866:Equipment Contamination / Q000517:prevention & control / Q000706:statistics & numerical data; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units / Q000145:classification / Q000706:statistics & numerical data; D007557:Israel; D008826:Microbial Sensitivity Tests; D011014:Pneumonia / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data; D014552:Urinary Tract Infections / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control