Nosocomial infections in intensive care unit in a Turkish university hospital: a 2-year survey.
OBJECTIVE
To determine epidemiology and risk factors for nosocomial infections in intensive care unit (ICU). DESIGN. Prospective incidence survey.


METHODS
An adult general ICU in a university hospital in western Turkey.


METHODS
All patients who stayed more than 48 h in ICU during a 2-year period (2000-2001).


RESULTS
The study included 434 patients (7394 patient-days). A total of 225 infections were identified in 113 patients (26%). The incidence and infection rates were 56.8 in 1000-patient days and 51.8%, respectively. The infections were pneumonia (40.9%), bloodstream (30.2%), urinary tract (23.6%) and surgical site infections (5.3%). Pseudomonas aeruginosa (22.6%), methicillin-resistant Staphylococcus aureus (22.2%) and Acinetobacter spp. (11.9%) were frequently isolated micro-organisms. Median length of stay with nosocomial infection and without were 13 days (Interquartile range, IQR, 20) and 2 days (IQR, 2), respectively ( P<0.0001). In logistic regression analysis, mechanical ventilation [odds ratio (OR): 16.35; 95% confidence interval (CI): 8.26-32.34; P<0.0001), coma (OR: 15.04; 95% CI: 3.41-66.33; P=0.0003), trauma (OR: 10.27; 95% CI: 2.34-45.01; P=0.002), nasogastric tube (OR: 2.94; 95% CI: 1.47-5.90; P=0.002), tracheotomy (OR: 5.77; 95% CI: 1.10-30.20; P=0.04) and APACHE II scores 10-19 (OR: 10.80; 95% CI: 1.10-106.01; P=0.04) were found to be significant risk factors for nosocomial infection. Rate of nosocomial infection increased with the number of risk factors (P<0.0001). Mortality rates were higher in infected patients than in non-infected patients (60.9 vs 22.1%; P<0.0001).


CONCLUSIONS
These data suggest that, in addition to underlying clinical conditions, some invasive procedures can be independent risk factors for nosocomial infection in ICU.
Erbay
Hakan
H
Department of Anaesthesiology and Reanimation, Medicine Faculty, Pamukkale University, Denizli, Turkey. rherbay@pamukkale.edu.tr
Yalcin
Ata Nevzat
AN
Serin
Simay
S
Turgut
Huseyin
H
Tomatir
Erkan
E
Cetin
Banu
B
Zencir
Mehmet
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D014421:Turkey / Q000453:epidemiology